1. Water Fasting, Intermittent Fasting, Healthy Eating and Jainism
Jina Shah, MD, MPH
July 3, 2017
JAINA Convention, Edison, NJ

2. Basics of Fasting Fasting vs. Starvation Why Fast? Fitness to Fast
Before the Fast
During the Fast
After the Fast
Jains fasts and considerations for change

3. What? Fasting vs. Starvation
Fasting: Consuming water only for a specific amount of time in an environment of complete rest Burning (Predominantly) Fat
Starvation: Exhausting the body’s nutritional reserves so that the structure and function of vital organs is harmed= Burning Muscles
Adapted from slides of Dr. Alan Goldhammer and Dr. Michael Klaper, True North Health Center

4. How much reserve energy can we draw on for a fast?
For 70kg male, 18% fat
12.6kg fat reserves
117,000 calories
BMR of 1kcal/kg/hour= 70 day supply of fuel
Activity will double requirements, so ~ a month reserves
For 55kg female, 29% fat
16 kg fat
148,571 calories
If BMR were 1kcal/kg/hour (likely lower)= 112 day supply of fuel
Activity will double requirements so≥ 2 months reserves

5. Metabolic “gears” of the body
Gear 1: Glucose, 1 hour
Gear 2: Gastointestinal, up to 6 hours
Gear 3: Glycogenolysis (breakdown of stored glycogen) hours
Gear 4: Gluconeogenesis and Ketosis(Breakdown of certain amino acids and fats) from 72 hours on, shifting to Ketosis with greater rest and longer fast
*Ketones are breakdown products of fat, suppress hunger; and promote well being*
Gear 5: Catabolism of body proteins with depletion of fat reserves
Adapted from slides of Dr. Alan Goldhammer, True North Health Center, Chapter 37 by Goldhammer et al,
Textbook of Natural Medicine, 4th Edition and Longo et al. Cell Metabolism 19, February 4, 2014 ª2014 Elsevier Inc

6. Why come to True North to fast?
Detoxify or reboot
Hope to heal illness
Diabetics (Type II)
High blood pressure
Headaches
Intestinal inflammation
Allergies & Autoimmune diseases
Adapted from slides of Dr. Michael Klaper, True North Health Center

7. Fitness to Fast Should not fast if:
Lab work and a physical exam are done to ensure that there are no severe medical conditions with weight loss, eg cancer
CBC, Chemistry, Urinalysis
Should not fast if:
Type 1 Diabetics
Medications can’t be stopped-- can do juice fasts
Young children and pregnant women
Elderly are seen at True North but less evidence of benefit
Adapted from slides of Dr. Michael Klaper, True North Health Center

8. Why fast? Effects of fasting (1)
Organ rest: Use all the energy (80%) we use in digestion to heal
Detoxification (cleaning our cells with pure water) - may be responsible for many of the unpleasant symptoms
Fat, cholesterol breakdown products and toxic chemicals stored in fat are released (eg PCBs)
“Autophagy” cleaning up damaged proteins and DNA

9. During the fast: What you might feel
Foul taste in mouth
Increased Body Odor
Fatigue
Headaches
Sleep disturbance
Restlessness and Irritability
Dizziness
Aches and Pains
Nausea and Vomiting
Diarrhea
Rashes and Discharges
Euphoria
Increased Energy
Healing Crisis
Nausea, bile usually carried with food but with food can reflux into stomach and can vomit bile. Carbonated water can allow pylori sphincter
Adapted from slides on fasting by Dr. Alan Goldhammer, True North Health Center

10. Why fast? Effects of fasting (2)
Balance hormones. Eg. Insulin
Initially Insulin resistance but long term increase in insulin sensitivity
Insulin receptors cleaned of fat from inside
Similar in some ways to effect of exercise
Decrease blood pressure- one way is by release excess sodium from the body

11. TYPE II – INSULIN RESISTANCE
INTRAMYOCELLULAR LIPID CLOGS THE INSULIN RECEPTORS FROM THE INSIDE
MUSCLE CELL
so blood sugar
goes UP
Slide courtesy of Dr. Michael Klaper, True North Health Center

12. Why fast? Effects of fasting (3)
Stop cancer growth factors
Stop Gut leakage- stopping food allows intestines to heal from food reactions
Decrease cravings and break addiction to “Pleasure trap” tastes- salt, oil and sugar
Adapted from slides of Dr. Alan Goldhammer and Dr. Michael Klaper, True North Health Center

13. Why fast? Effects of fasting (4)
Increase blood flow
Decrease Leg pain, chest pain
Enhance Immune system- Inflammatory conditions improve, whether in joints, organs, skin
Ramp up longevity and resilience pathways
Adapted from slides of Dr. Alan Goldhammer and Dr. Michael Klaper, True North Health Center

14. How does oil block our arteries?
Plaques of atherosclerosis can build up in the arteries…
Slide adapted from Dr. Michael Klaper, True North Health Center

15. Conditions that have been helped
Hypertension (published population data)
Lymphoma (published case study)
Rheumatoid arthritis
Crohn’s and Ulcerative Colitis
Chronic Headaches
Diabetes
Fibroids

16. How long to fast and where
To detox or“reboot”: 1-5 days
To arrest or reverse disease: days
Recommended to be medically supervised if fasts longer than 3 days
> 5 days if healthy
Allow at least half the time of the fast for re-feeding
Adapted from slides on fasting by Dr. Michael Klaper, True North Health Center

17. Before the Fast
Fruits and Vegetables only 2-3 days so reduce risk of constipation
Stop all medications because side effects will be potentiated (medically supervised)
Thyroid medicine reduced by ½
Stop all supplements- side effects
Stop cosmetics, toothpastes, mouthwash
Adapted from slides of Dr. Michael Klaper, True North Health Center

18. During fast: Lab tests Cholesterol and triglycerides Uric Acid- 
Short term 
Long term as fat clears out of cells 
Uric Acid- 
Liver enzymes- 
Since these are normal metabolic changes – avoid getting blood tests done for 60 days after the fast
Adapted from slides of Dr. Michael Klaper, True North Health Center

19. During fast: how much water to drink?
Need less water- less waste excreted
Drinking too much water can result in electrolyte problems
Fat releases water when metabolized
Drink about 3-4 glasses of water
Generally 1 glass more than thirst

20. During the fast: What you might feel
Foul taste in mouth
Increased Body Odor
Fatigue
Headaches
Sleep disturbance
Restlessness and Irritability
Dizziness
Aches and Pains
Nausea and Vomiting
Diarrhea
Rashes and Discharges
Euphoria
Increased Energy
Healing Crisis
Nausea, bile usually carried with food but with food can reflux into stomach and can vomit bile. Carbonated water can allow pylori sphincter
Adapted from slides on fasting by Dr. Alan Goldhammer, True North Health Center

21. Warning signs after fasting >3-5 days: Stop the Fast
Irregular heart beat, especially in someone with heart disease
Wiry insistent pulse (on check by experienced doctor)
Lightheadedness on standingFainting
Severe vomiting
Disease Complications
Severe headache
Extreme weakness

22. After the fast: refeeding gradually
Per Valter Longo, refeeding is most important part of rebuilding the body after a fast turns on stem cells
1-2 days of refeeding for each day of short fast, 2-3 days for longer fast
Juice or steamed zucchini chunks, then fruit, then steamed or raw veggies, then grains, and then legumes added for a full all plant diet

23. After the fast: refeeding schedule and preventing constipation
w7+1 = 1st day of re-feed, 2 juices, then raw food for dinner
w7+2 = 2nd day of re-feed, raw food for breakfast, then steamed food +raw food for lunch & dinner
w7+3 = grains + steamed food +raw food for breakfast & lunch, then unlimited for dinner
w7+4 = unlimited
Give prunes and senna tea if no BM for 2 days and if not enough, enemas or suppositories

24. Intermittent fasts
Much research has been done recently on intermittent fasts with benefits to longevity, cancer, MS
There are many different variations
Eat 5 days, Fast 2 days
Alternate day eating (like varshitap)
4-5 day fasts every 2 weeks
Some question of sleep wake cycles (circadian rhythm)disruption

25. Jain fasts Atthais are 8 day water fasts often done annually
Just before Atthais, 8 day fasts, people may eat sugar, fat and starch laden sweets with heavy meals
Many attend work during fast
During parnas (refeeding) introduce mung broth, sweetened grains, tea and spicy drinks with milk on Day 1
Do people continue their medicines?
Varshitap, alternate day intermittent fasts
Ekasana, Besanu and Ayambil (intermittent fasts) heavy on grains
Taking chauviar vows not to eat at certain times (time restricted feeding)

26. What should we consider doing differently before and during fast?
Prepare for fast with graduated diet with just fruits and vegetables, juices, no dairy prior to starting fast
Rest, only gentle exercise and detach from work
Medical supervision if person has disease requiring medicines, and/or kidney, heart, liver, other serious disease and/or is elderly
Sponge batch, no bath or shower

27. What should we consider doing differently after fast?
Watch out for warning signs to end fast
Re-feed carefully and gradually
Low salt to avoid medical complications
Avoid dairy, introduce grains later
Maximize and sustain the benefits of a fast with a low salt, no sugar, plant based (healthy vegan) diet

28. Questions? Visit Ahimsak Eco-Vegan Committee table at JAINA booth
See postings on veganjains.com
Will post additional references and resources on our website

29. Healthy Diet, Not Fasting will lead to healthy weight loss- more in my next talk!
Slide adapted of Dr. Michael Klaper, True North Health Center

30. Acknowledgements
Dr. Michael Klaper and Dr. Alan Goldhammer, True North Health Center, Santa Rosa CA