Can fasting save your life?

Fifteen months ago I wouldn’t have believed it. That was until the NHS told me that they could no longer afford to spend £25,000 a year on a drug that was keeping me out of hospital.

I have had a serious autoimmune disease for almost 20 years, and it has made my life maddeningly, exhaustingly unpredictable. I have never been able to tell when I am going to be ill, or for how long. Sometimes I’ve been well for months, working, dancing and going to parties, and at other times I’ve become so sick that I’ve had to be hospitalised, or spend months lying listlessly in bed.

It’s made full-time, office-based work impossible. I left a job I loved as a BBC programme editor when my consultant warned me I was so frail that if I didn’t stop work before the next relapse, I might die. It cost me time with my children and my friends. The drugs I had to take for it crashed my adrenal system. And when I had breast cancer six years ago, the side-effects of chemotherapy made it all worse.

My doctors weren’t likely to win the fight to keep me on my expensive medicine, so the NHS’s guillotine left me searching for alternatives. Nobody had found a new drug. But there was some jaw-dropping research, which had just been published. Professor Valter Longo, a leading gerontologist from the University of Southern California who had been studying fasting for 25 years, had discovered that if mice were made to fast for three days, their bone marrow started to produce new stem cells. Occasional three-day fasts over six months left the mice with completely rejuvenated immune systems. If the same pattern were shown to exist in humans, it would mean that anyone whose immune system was ageing or faulty might be able to reset it.

I started my first fast almost by accident, during a bout of seasickness. It lasted almost three days. Like the mice, I drank nothing but water; unlike them, some of mine was hot and had tea bags in it. I gave it up because I was bad-tempered and ravenous and didn’t really believe it would work.

A day later, I found that almost all my symptoms had gone. A second fast six weeks later eliminated all of them. I was so astounded by the results that for the first couple of months I didn’t tell anyone how effective it had been. I was afraid that at any moment it would all go into reverse.

It didn’t. I have fasted for three or four days every couple of months over the past year, and have stayed well. I have stopped taking my cocktail of drugs. It has been, quite literally, miraculous. None of the medicines I have taken has given me this level of health. But fasting alone is hard, and in the past few weeks, as the memory of being ill recedes, I have kept finding excuses to give up on Day 1. There’s always the temptation to eat cheesecake or open a bottle of wine. So when a friend told me about a fasting clinic where all choices are removed, and where experienced staff know exactly what to do when you feel discouraged or dejected, I knew I ought to go.

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The Buchinger clinic was set up 60 years ago by a man who had recovered from incapacitating arthritis in his thirties by eating nothing for 20 days. Otto Buchinger became a fervent believer in holistic, naturopathic medicine. Now the two Buchinger clinics – there’s a second in Marbella – treat 5,000 clients a year, most of them fasting for between 5 and 20 days at a time.

Dr Françoise Wilhelmi de Toledo, the wife of Buchinger’s grandson and the clinic’s managing director, is a glowingly beautiful woman in her late sixties who is a devotee of annual fasting. She says the first three days are hardest, as the body adjusts to using its own fat as fuel. After that, fasters should have plenty of energy; they are using their own. Many report that fasting makes them feel euphoric, creative and exceptionally alert. I perk up at that. Perhaps I’ll dash off a novel while I’m here.

She, like everyone else in the fasting world, is tremendously excited by Valter Longo’s research. A week earlier he was at the clinic to take part in a conference. “We have always known that fasting works, because we see the results here,” she says. Fasting for several days at a time leads to immediate drops in high blood pressure, cholesterol, insulin levels and inflammation. “What Longo is discovering is why.”

Buchinger’s philosophy is that it is a clinic masquerading as a hotel. People deprived of the pleasures of eating must have others to compensate: beautiful views over the lake, pretty landscaped gardens full of flowers, an elegant heated outdoor pool, guided walks in the woods, saunas, yoga, art classes, meditation, concerts, massage. But the backdrop to everything that it does is medical attention and a high level of nurturing.

Everyone sees a doctor twice a week and takes a blood test on arrival, to analyse their state of health and have treatments prescribed. You see a nurse each morning to have weight, blood pressure and wellbeing checked, and while you are fasting a nurse tucks you into bed with a liver compress every afternoon for a rest, and leaves a hot-water bottle in your bed each night. The nurses are on call 24 hours a day, and clients are encouraged to ring their bells at any time, whether because they are cold and need hot tea, or are faint and hungry and need help. It’s like regressing to a childhood most of us never had, with a succession of solicitous nannies permanently to hand.

The doctor I meet, Dr Norbert Lischka, is a jolly, radiantly healthy and slender man in his sixties. He says there is nothing odd about fasting. It is what humans were designed to do – switch from feast to famine. What is unnatural is to eat constantly from January 1 to December 31. We are surrounded by plenty and our bodies cannot cope with the onslaught. It is like driving a car with the accelerator pedal constantly down.

Fasting lets the body pause and repair itself. After 12 hours or so of ceasing to eat our cells go into a state called autophagy, where they start scavenging for tumours, viruses and diseased or damaged cells to use as fuel. It is the body’s chance to rid itself of anything it doesn’t need. Fat cells are depleted and any toxins they have stored are released into the bloodstream.

I tell him I want to try fasting for as long as possible in this stay; if three days is good, surely nine days would be better. I’d like it to go to work on my immune system, and since fasting is also thought to kill cancer cells, I’d like it to starve out any of mine that might have evaded chemo years before. That will be followed by a day of breaking the fast, and three days of gradually refeeding to raise the metabolism and accustom the system to food. After the fast, as the body rebuilds, the theory is that its tissues will be stronger and healthier than before.

I jauntily assume that the fasting will be easy, since I’ve done it before, and this is fasting helped along by some actual food. I weigh 9st 8lb the day I arrive. Day 1 is fine, and the thin, 100-calorie soups, served in the salon overlooking the lake, are something to look forward to. But when a friendly American academic asks if he can join me at my table on the first evening I say yes automatically, then realise I’m rigid with dismay. He’s nice enough but I fiercely resent making polite, distracting conversation when, like a caveman jealously guarding the bit of rare bison in front of me, all I care about is concentrating on every one of my ten spoonfuls of food. I decide that from now on I’ll eat with a book held protectively in front of me at all times.

On Day 2, with some scepticism, I try the clinic’s exercise regime. When I have fasted alone I have done nothing but sleep, read or watch box sets. Here gentle activity is recommended to keep the muscles and lymph system moving.

I get up at 5.30am to join 50 others for the daily 75-minute walk through meadows and woods as the sun rises. Our group includes Saudi and British doctors, Israeli businessmen, a Buddhist ex-monk, a mother of seven from Surrey and powerful, stylish women from the UN and World Bank. Some people are startlingly, waddlingly fat; some are strikingly long and lean.

A healthy French couple come every year because they leave feeling so well. A short businessman with a huge paunch comes twice a year for a fortnight to lose the same stone. Without Buchinger to keep him in check, he says, he would be fat and dead. A slender Dutch economist is there because she developed crippling rheumatoid arthritis within days of having a second baby six years earlier. Fasting once a year for eight days, alongside avoiding the five foods she reacts to, is enough to keep the symptoms at bay. For her, weight loss is a tiresome, temporary side-effect. “When I leave,” she says, “I am scary thin.”

I come back to my room exhausted but on a high from the combination of natural beauty and exercise. I tell the nurse I feel limp and when she takes my blood pressure she isn’t surprised; it’s fallen to 80/60 from 110/80 the day before. I am now 9st 6lb. I must increase my water intake to 5 litres a day and take a couple of tablespoons of salty, watery gruel with my tea and honey to bring the blood pressure up. I eat the gruel and realise there’s a reason why no one but Dickensian orphans has ever asked for more. I go back to bed and have the lunchtime soup in my room, too tired to join the salon.

It is baking hot: 36C. After lunch I drag myself up the short slope to the medical centre for an appointment, utterly drained. The room starts to darken while I am on my chair; I collapse onto the floor. Anxious nurses surround me instantly, taking my blood pressure and pricking my finger for a blood-sugar test. Both are too low, so I am escorted back to my room, stumbling, and brought an apple juice. It is intoxicatingly delicious, and I drink it a teaspoon at a time over two hours.

I haven’t the energy to get out of bed again that day, or even to read. At 9pm, when the night nurse comes to bring a hot-water bottle, she says firmly that I must eat a yoghurt. It is only 90 calories, and as long as I stay under 400 calories a day I won’t negate the effects of a fast.

On Day 3 I bound out of bed at 5.40am, join the walk to a castle, go to the gym and a yoga class, have six vials of blood taken for the medical tests, and think: this is the turning point that other fasters keep telling me about. I am going to feel marvellous from now on.

Day 4 is miserable. The dawn walk, along steep stony paths, is a grim exercise in willpower. I walk in silence. My blood pressure has fallen back. I don’t leave my room again except to walk 30 metres for two varieties of blissful, soporific massage. I don’t have the energy to talk to other guests. I was terrified of running out of something to read, so I brought 14 interesting, taxing books with me. Now I lie looking at them: Robert Caro’s biography of Lyndon Johnson; Sapiens: a Brief History of Humankind by Yuval Noah Harari; Dan Jones’s The Hollow Crown. My brain is fuzzy and slow and I can’t manage any of them. Nor can I see to read clearly; fasting has temporarily changed my eyes’ focal length. Instead, I download the audiobook of Queen Lucia, EF Benson’s gently comic, soporific novel.

The morning of Day 5 is no better. I get up for the walk, which is the highlight of the day, but feel woebegone. My back aches, my legs are weary and my skin is deadly white. My fellow fasters seem odiously cheerful. One is seeing her eczema vanish; another has lost the crippling pains in her knee. I don’t feel hungry, just weak. I wish everyone didn’t keep promising energy and euphoria, because I have neither.

I see my doctor for some test results. I have very low levels of vitamin D, common in the West, and a high risk factor for cancer and immune diseases. He recommends infusions for several other vitamins whose levels aren’t optimal. But after a year of fasting my inflammation levels, which have been perilously high for 20 years as my immune system malfunctioned, are exceptionally, healthily low, and my cholesterol count, which should be less than five, is a highly desirable one.

I ask him why I am so feeble and he says thin people often find fasting much tougher than fatter ones. They have less to live on.

He prescribes a yoghurt every morning, starting immediately. I am desperate to taste something other than honey, herbs or broth. Back in my room I hunt through all my bags in the hope of finding a forgotten chocolate or nut. I am thrilled to discover two pumpkin seeds in their shells. I break them open and drop them into the yoghurt, savouring each exquisite, tiny bite.

I have a sudden burst of energy and go to yoga, the sauna and the gym, though I have no balance and fall over every time I have to stand on one leg. The next day I flatline again, with leaden limbs. I am 9st 2lb. My shaky fingers aren’t strong enough to break the catch on the shampoo bottle. Utterly dejected, I spend most of the day in bed waiting for time to pass. The night nurse tests for blood sugar; mine is now ludicrously low. My body isn’t generating the glucose I need from my own fat. It’s why my brain and muscles have turned to sludge. She gives me a supply of glucose tablets to be taken a quarter at a time.

Days 7, 8 and 9 are more bearable even though I only take one glucose tablet a day. At last I look pink and my skin is glowing. I have lost almost 9lb, though much of that will be water weight. But my head is still foggy and I am often limp. The staff are kind and capable, the masseurs outstanding and the activities distracting, but my body is finding this brutally hard. If this were the savannah, a lion would have snapped me up long ago. My stomach is aching with emptiness and I long to start eating again. Many fasters report feeling so good on fasts that they can’t bear to stop. Not me. I couldn’t bear to do another day.

I wake on Day 10 deliriously happy and excited; we’re to break our fasts at lunchtime. A friend and I walk down to the village in the morning and when we see free nuts and dried fruit in a health shop, we take a single walnut and a single large flat raisin, and share them on the way back, half each. We can’t believe that we once had a life where we ate nuts by the handful. “This tastes like wine!” says my friend reverently, as she takes minute bites of her raisin. And I agree.

Breaking the fast is disappointing. We want real, filling, savoury food – I long for fish, beetroot and eggs – but get only apple purée, followed in the afternoon by an apple and four nuts. Supper is soup with fragments of actual vegetables. I go to bed starving – my stomach has woken up and is demanding more. It’s only the next morning, after breakfasting on spelt porridge, that I get up from the table feeling full and energetic. It is my birthday, so I celebrate it with a treat: ten sunflower seeds.

I leave three days later, 6lb lighter than I arrived. I am 9st 2lb. Much more importantly, since I didn’t come to lose weight, I look well and I feel physically deeply peaceful and content. But I don’t know what has happened to my body beneath the surface, and the clinic doesn’t know either. They don’t routinely test guests on departure or do follow-up research. They just assume, from what they witness, that it must be good. Are they right? And is this level of deprivation worthwhile?

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The person who thinks he has the answers to these questions is Valter Longo, the man with the mice, who is seeing dramatic results from his fasting research. He first discovered the power of fasting in the Nineties, when he starved yeast cells of sugar, replacing their food source with water. Instead of dying they lived longer and became stronger. The results were so counterintuitive that, at first, reputable journals refused to publish them. But the same turned out to be true of bacteria and of mice.

“The ability to switch into hyperprotective strong mode [while starving] is billions of years old,” he tells me. “This is a mechanism that’s as old as organisms themselves.”

In the past ten years Longo has discovered that fasting can be as effective as chemotherapy cycles in cancerous mice. Cancer cells are far more vulnerable to starvation than normal ones. Combining the two, so that mice are fasted for three days before chemo and a day afterwards, multiplies the effect.

Ordinary cells react to starvation by reducing the activity of certain genetic pathways. Cancer cells can’t do that. During fasting they become more sensitive to the poisons in chemotherapy, while the healthy fasted cells are largely protected from those effects. In trials of several breast cancer drugs, every mouse given chemo alone died, while every mouse who was fasted before and after chemo survived.

With the stem cell and cancer breakthroughs behind him, Longo is now a man in a ferment of excitement about fasting’s potential. In co-operation with universities in Europe, America and the UK, including the Mayo Clinic in Rochester, Minnesota, and University College London, he is running mice and human trials of several different diseases. He thinks we are just on the verge of understanding fasting’s immense potential to regenerate organs and reverse disease. His laboratory has funding for cancer and diabetes research; he’d like to do much more to investigate Alzheimer’s, cardiovascular diseases, autoimmune conditions and multiple sclerosis, too.

Longo believes that fasting could help billions. But, he says, precisely because it can be so potent and effective, it should be used with great care – and only when the evidence justifies it. It can be deadly if done badly, and the majority of fasters find it very physically and psychologically taxing. The last thing anyone should be doing is to launch into fasting on their own, as I did, or without the clinical data to back it up. He’s been following human fasters since 2007.

Most religions and traditional cultures use fasting in some form – Lent, Ramadan – but Longo warns that tradition doesn’t make it safe. “People think fasting is no big deal, but in fact it’s the most powerful medical intervention you can make,” he says.

Almost everyone, he tells me, could have problems fasting without expert supervision. Obese women who undergo certain types of fast can develop gallstones. I blacked out on a hot day; what if I had been on one of my lone fasts and driving at the time? Or what if a diabetic fasted while on metformin or insulin? They wouldn’t produce the glucose needed for the brain to function, because metformin is a glucose production inhibitor, so that could be a deadly combination. It would be equally disastrous to fast during chemo without following the tested protocols precisely. The fast must be maintained for 24 hours after the chemo is given, because the moment a fast ends, the body begins to regenerate using whatever fuel is in the system. Stopping prematurely means that the system would be rebuilding just as the chemo poisons were circulating in the blood, potentially generating a high level of mutations.

He is equally careful about recommending fasts longer than a week, such as those at Buchinger. He says the clinic does admirable work and has a great safety record, but he adds reliable studies simply haven’t been done. Anecdote and assumption are no substitute for research. He points out that 200-calorie fasts create an extreme lack of vitamins, minerals and proteins, and cause muscles and organs to shrink. A 63-year-old man could lose 15 per cent of his body weight on such a 3-week fast, pushing his heart, liver and muscles into severe atrophy before they are regenerated. “What happens in an older person when organs are rebuilt so rapidly from such a low point?” Longo asks. In mice, nearly half the white blood cells disappear after just three days. “In humans, we just don’t know.”

Longo believes that he has come up with an answer to these problems. He has devised a way of giving people all the benefits of fasting, with its regenerative, anti-ageing and anti-disease effects, without the intense physical stress. After decades of biochemical research, and eight years of experiments on humans, he has developed a five-day fast-mimicking diet (FMD).

The FMD is a five-day programme of bars, shakes and soups, all made from real food. Its published results show that it lowers the levels of the protein IGF-1 in the blood, which is a major biomarker for cancer and ageing. It lowers blood sugar, which reduces the risk of diabetes, and it lowers blood inflammation levels. Longo describes it as “truly rejuvenating”. Trials conducted over a year show that regular use of the FMD – perhaps twice a year for healthy people, once a month for the seriously sick or the obese – has a dramatic effect on health. Testers find it palatable and possible. He was expecting a dropout rate of 50 per cent; only 5 per cent didn’t complete it.

Longo says that the key to the FMD is that it will be both preventative and curative, stalling the hidden degeneration of our bodies. Most middle-aged people believe we’re healthy. Yet the majority of us in the West already have cholesterol, blood pressure and IGF-1 levels that will cause problems in ten or fifteen years unless we can bring them down. The FMD, used in conjunction with modern medicine wherever that’s appropriate, and integrated into the medical system, might do that.

Longo is waiting for final approval from America’s Food and Drug Administration and hopes that the FMD will go on worldwide sale from this autumn. It will cost around £165 a time, including a consultation with a supervising clinic. He hopes that here, eventually, doctors will prescribe it and either the NHS or insurers will pay. Longo will not make a penny from it. All his shares in L-Nutra, the company selling the FMD, will go to a foundation dedicated to funding creative research.

Of all the criticisms raised by doubters, the one that most enrages Longo is the suggestion that fasting is an unsophisticated intervention. It is, he says, quite the opposite. His detailed research is mapping exactly how fasting works at a cellular level to identify and eliminate bad cells and generate new healthy ones. So much of modern medicine is unbelievably crude in comparison. Many drugs deal with symptoms and not causes. It is, he says, the equivalent of opening a car bonnet after hearing a knocking sound, ramming sticks through the engine until the noise stops, and calling that a cure. Five drugs can mean five sticks through the engine and five blockades in the system, with minimal understanding of the long-term consequences and side-effects.

He is intensely frustrated by the difficulties in getting fasting research either fully funded or accepted. If fasting were a drug, the potential rewards would be in the billions, so pharmaceutical companies would have huge budgets to investigate and promote it. He has nothing like that behind him, because no one stands to make a fortune from what he’s trying.

“So many doctors say they won’t touch this. They don’t want to know it or read it. It’s not what was taught in med school,” he says. “But this is the new med school! This is what I teach the next generation of doctors! I believe this will soon be part of the standard of care. We’re in a war against so many diseases, and if we just had a bit more funding – maybe £10 million – we could be making big breakthroughs in 18 months, 2 years. Patients need the results now.”

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We do. I am glad I didn’t wait for anyone in the health system to give me official encouragement to fast; I’d still be waiting now, and I’d have spent yet another year being ill.

What have I learnt, 14 months into my own fasting experiment? First, that for some of us it’s better than any of the alternatives medicine has to offer. If you’re very rich, very anxious, very fat or very sick, it might well be worth going to Buchinger once a year. If I could afford its hefty prices, I’d want to go again, though this time I’d only fast for five or six days. It changes habits and it kick-starts weight loss. Three weeks after leaving I still feel healthier and more peaceful than I did before, and I’m still more than 4lb lighter despite expecting to put that weight straight back on. I have always been a restless, absent-minded grazer, but now I’m less inclined to eat chocolate or sugar, much keener on vegetables and nuts, and I’ve learnt to enjoy the feeling of emptiness between meals.

Clinics such as Buchinger Wilhelmi, though, will never be an option for most of us, in terms of either time or money. The FMD sounds like the best possible balance between effectiveness and deprivation, which is why I am desperately hoping that it will be approved. I could continue to work while on 750 calories a day, which I could never do on classic fasts. I’d want to do it every couple of months. If I had a lot of weight to lose or a serious health issue, I’d want to try it six or twelve times a year.

What can we do for ourselves, though, to get the benefits of fasting if the FMD doesn’t get licensed, or if money is tight? If weight loss is the only issue, then the 5:2 works. But if it’s the regeneration of the immune system or the anti-ageing effects we’re looking for, fasts need to be longer than that.

I’ll carry on doing my own three or four-day fasts every eight weeks or so, scheduled at times when I don’t have to write, cook or go out, but now I know they needn’t be so harsh or so solitary. For the first year’s fasts, knowing no better, I followed the mouse protocols and ate no calories at all. In future I’ll have 300 to 400 calories a day of high-quality liquids, mostly as vegetable or miso soups, and when I feel faint I’ll know it’s either a problem with blood pressure or blood sugar, so I’ll have water and glucose tablets to hand. I also know now that I was an idiot not to check with my GP before I began. I might have had kidney or liver problems, or been taking drugs that either couldn’t be stopped abruptly, or couldn’t be swallowed on an empty stomach.

But inventing my own fasts in the face of medical scepticism will be a third-rate option when the tantalising possibility remains that fasting could be an effective answer to so many of the ills that plague us in the West, from obesity to diabetes and heart attacks. I share Longo’s intense exasperation. He isn’t claiming that fasting is an answer for everything. He just wants its possibilities and its limits to be properly explored, so that where it does work, health services can be confident about taking it up.

I think of my own doctors, who smile patiently at me when I say that in my case fasting’s been an apparent cure, and who explain that they can’t recommend it to anyone until they see clinical proof. I think of all the months and years I’ve wasted on the tedium of being ill, and of the millions of people who could be similarly liberated to have more joyful, longer lives if Longo is right. I think of the billions that governments will save if people can choose to fast instead of relying on hazardous, expensive drugs. And I hope that the health and medical establishments will take their fingers out of their ears and give this radical prophet the hearing and the resources he’s asking for.

@jennirsl

Jenni Russell was a guest of the Buchinger Wilhelmi clinic and took part in the 14-night Classic Light programme, which includes fasting provisions, a holistic programme and medical consultations (from £2,237). To book, go to buchinger-wilhelmi.com