Does Fasting raise risk of Death?? | Fact-checking headlines
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- Опубліковано 27 кві 2024
- Headlines this week reported a link between Intermittent Fasting and 91% higher risk of dying of heart disease. Let´s look at the evidence and its implications. Does fasting raise risk of dying of cardiovascular disease?
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References & Additional Resources:
Poster: s3.amazonaws.com/cms.ipressro...
Press release:
newsroom.heart.org/news/8-hou...
Abstract: www.abstractsonline.com/pp8/#...
Interview: www.nbcnews.com/health/heart-...
Skipping breakfast & health:
www.sciencedirect.com/science...
www.bmj.com/content/364/bmj.l...
www.mdpi.com/2308-3425/6/3/30
onlinelibrary.wiley.com/doi/a...
www.jstor.org/stable/40967841
NHANES study:
www.sciencedirect.com/science...
Harvard study:
www.ahajournals.org/doi/full/...
fasting RCTs:
pubmed.ncbi.nlm.nih.gov/29419...
jamanetwork.com/journals/jama...
early eating & health:
www.cell.com/current-biology/...
onlinelibrary.wiley.com/doi/f...
Disclaimer: The contents of this video are for informational purposes only and are not intended to be medical advice, diagnosis, or treatment, nor to replace medical care. The information presented herein is accurate and conforms to the available scientific evidence to the best of the author's knowledge as of the time of posting. Always seek the advice of your physician or other qualified health provider with any questions regarding any medical condition. Never disregard professional medical advice or delay seeking it because of information contained in Nutrition Made Simple!.
#NutritionMadeSimple #GilCarvalho
0:00 Headlines
1:27 New study
3:45 Smoking, race & food quality
5:18 Stress?
6:04 Muscle mass
7:20 Breakfast skipping
11:12 Takeaways
12:43 Time of eating
I started 18/6 IF in November, increased my exercise, continued eating healthy low carb/sugar & lost my final 20lbs (total loss 44). This has resulted in remission of my decade long type 2 diabetes! My BMI is 20.6, BP perfectly normal, RHR decreased to 62 from 75, off my diabetes meds, increased muscle mass (weights)...all this as a 63 yo woman! I am never looking back as this is my lifestyle forever, as I am healthier than I've ever been. Thank you for your review! The health benefits for me have been huge with ALL the changes, including IF.
😊 👏🏼 👏🏼
So how do you know it’s not your exercise that did it. It seems you’re applying IF for all the positives you experienced.
nothing works forever! if you started in november it is understandable. but when you "milk it" don't freeze on this. when will be right time for change, just do it and don't turn around. you can't enter same river again...
@@LogicSpeaksLoosing all this weight just with exercise is extremely difficult, especially at that age...Everything contributed for sure, but more than anything the IF I would argue, since that was the big change in her lifestyle....
I'm currently in full fasting for 9 days, with the first 6 days being dry fasting. Now I drink water and thyme tea. I cooked a pot of red peas soup on Sunday and I've got a Easter Bun ready to be eaten with cheese, but I haven't touched either. I'm fasting for good health and not to lose. I can definitely tell that I need to eat more B1 vitamin and magnesium foods or supplement.
I don't eat breakfast, because I am not in the least bit hungry, so the food consumption timeframe for me is noon to seven. I don't have high blood pressure, diabetes, over weight issues, or high cholesterol. I'm a senior citizen, fit and trim, work out, and eat healthfully.
That doesn't have a lot to do with fasting... Everyone's different.. you could be genetically gifted (all my uncles have hypertension and diabetes except the middle one..he doesn't do anything right.. doesn't eat well .. doesn't excercise...but he doesn't have diabetes or hypertension and he's in his late 60s.. he's never been a good person ..even smoked before giving up a couple of years ago..)
Plus, eating all your food before evening is actually better for the body ... People lost more weight even they skipped dinner then when they skipped breakfast.. metabolism is probably faster...
I'm never hungry in the morning or at lunch. I usually get hungry between 4pm and 10pm (I was a night owl, 3rd shifter for many years), one meal a day, sometimes with a small snack in the early afternoon. My mother did this most of her life, she passed at 94. I'm a senior now as well, fit and trim. I did have high cholesterol so switched to a WFPB diet, it's way down now.
I do love my morning coffee tho, just 16 oz, a daily pleasure!
Was there a negative outcome when you weren't skipping breakfast
@@brucejensen3081 - None whatsoever, but I ate breakfast back then, because I was hungry during that period of my life.
Thanks for the anecdote, I will make sure to use it in my meta-analysis of youtube comments
I love fasting!
I'm 100 lbs down because of fasting!
Thank you!
Well fasting as a life style and fasting for weight loss aren't the same. Not saying fasting is bad in any way, just saying they're not the same and it's a significant difference because of course it is good to lose weight if you're overweight.
Oh, no! Run to the ER now before you get a heart attack!
I'm down 101lbs from eating. eating>fasting.
It might be better if she walked to the ER, rather than run there.@@cdprince768
Glad you found something that works for you 😊. I’m assuming you imporved the quality of your diet too ?
I'm fasting for 4 years now. Never felt better .
I suspect that you did eat something, over the past 4 years.
4 years?!?
You must be really hungry now.
@@brocklastname6682must have been huge to go 4 years without eating once. Lol
@@brocklastname6682 I just eat ice cubes and salt. Try it. It's a must.
Lmao this is superior kind of humor
Hope this channel keeps growing. We need rational people interpreting science.
Definitely yes.
I'm 76, started at age 70 with intermittend fasting , fasting from 16 to 18 hrs fasting, lost 70+ pounds, lost my high blood pressure, lost my borderline blood sugar and work out about 5hrs - my average bmi is 24+. Breakfast for me is around 11:30 am to 12:30 pm. I sleep good according to my fitbit for 6- hrs and feel better than I did at 56. Eat chicken meat or fish about 3-4 times a week and lots of fruit and vegetables - no alcohol and do not smoke. do not eat after 6 pm
I was waiting for your contribution on this subject! Excellent as always
Yep.
Thanks Gil. 👌🏽
And yea, we do care. It's great to be able to relate to a very clever medical research profess(or)ional who's entirely objective and honest.
The biggest limiting factor is probably still how well you can stick with a healthy diet
Thank you for addressing this question, at the request of your many viewers. I have my own field of study and work to maintain--rather than fully investigating every item in the "news"--It seems irresponsible of the media to have hyped this poster to this level. So, i appreciate the time you took to put it in context for people who have limited time and yet care sincerely about their health. The review of how to understand and evaluate medical news is also good. In the end, im concluding that some newswriters care more about eyeballs than us, the readers.
As I understand it, the people were assigned to the groups "8h" etc. based solely based on a questionnaire of when they recalled eating for the last two days years before filling out the questionnaire. Did they continue to eat in the same pattern for the next 8 years? There is no way to know.
Been using IF for 10 years. It’s made gaining fat very difficult. I think we will be fine
The more interesting conversation isn’t about the findings themselves, it’s about why the media pushed it so hard.
Exactly
No mystery there. Clickbait = more clicks = higher ad revenue. Hiring real health journalists to pour through data and responsibly report is expensive and doesn't have the same return-on-investment.
Because calm, measured, carefully worded, accurate reports are not viral.
Which is why this yt channel is so criminally underrated.
The old saying "If it bleeds it leads" is as relevant now as it ever was.
I'm annoyed enough when a study ends up strait to the media without context. Now just studies in progress? /o\
ToT
Remember corona, when Researchers published their preprints so other researchers could double check them before peer review, and all the media outlets would take those preprints at face value without any scientific literacy.
its up to the consumer (of information, food) to be informed, which is hard!
Imagine how this affects elections, knee jerk medical recommendations, etc.
Love you Gil, you're the best. Thank you for all the valuable information.
Gil- many thanks for continuing to inject reason and science into nutrition discussions.🙏 You’re the best!!
Thank you for lending a scientific perspective and interpretation of the poster presentation. I love your ability to bring statistical findings down to the level a lay person can understand. Great job! Worth listening to you!
Thanks for another calm sensible analysis.
Always appreciate your balanced observations.
Thank you Dr. Carvalho for putting all this frenzy in context bringing sanity into the whole issue.
Posters! Huh.
Was hoping that you'd cover this, and as usual you didn't disappoint. Thanks Doc
saw this for the first time last night.knew you'd cover it soon.thank you again!
I once fasted for two days and broke my fast with an all-you-can-eat Chinese buffet. For three hours afterwards, my heart felt like it was trying to come out of my chest, and my pulse rate was 103 bpm, even with no activity.
That scared me enough to investigate the correct way to break fast. It really did feel like I was going to die.
Yep, it's called refeeding syndrome and actually there are numerous cases of people dying after prolonged period of starvation when getting proper food. This happened in Nazi concentration camps, when allied forces came and brought food to those poor people and in some other similar situations.
Its pretty dangerous to eat a lot after a prolonged period of fasting
Oh man. I went through something similar but didn’t think anything of it.
Moral of story, don't load up on msg after a starvation period
@@Nic1963Dbit racist
Always a pleasure to watch one of your videos 🤩🙏
Thanks for the information 👍🏽
I was really hoping you would do a video about this Gil.
Perfect summary! 👌
Great analysis... even with the little information available about this study.
Thank you so much! You are a reliable source of info.
You've taught us well that correlation does not equal causation! When I saw the headlines of this study I was hoping you would do a video about it. Thanks Dr. Gil!
Thank you Sir!
Very well interpreted. Thank you.
Great video as usual.
Very well done, again!
Thanks informative explanation 👍
Good stuff, thanks!!
Thank you for covering this so promptly
Hopefully we will know the truth of the matter in the fullness of time
People get invested in what they want to be true
I am invested in adapting to the truth
The irony is that I have seen so many IF "influencers" jumping on anything portraitaing IF as superiour, no matter how small. Everybody needs to chill out a little...
Good luck with that...🛹 , Defunding public education for> 60yrs was a brilliant strategy usa...
Imagine how reliable this research would be for them if it has shown the opposite result...😌
Nicely evaluated
Great video!
Good discussion well presented to make sense of the subject.
Skipping breakfast is one thing and the opening hour of food is another. As you mention, doing fasting (forced fasting) and injesting junk food is deadly indeed. But if you have your breakfast at noon and last meal at 6 or 7 pm, you eat whole natural food (unprocessed), every single marker will definitely improve. Concering calories, it depends from where it comes from. So yes, focusing on what you eat is crucial (that's the root of all evil). Fasting 14 to 16 hours, following a healthy diet will reverse many bad issues.
I really like this guy. He's fun to listen to, doesn't talk down to us, and really really knows his stuff.
É assim mesmo, Gil!
Did they monitor for caffeine intake? When I used to do 16/8 fasting I would really hit the caffeine hard.
Caffeine intake is associated with lower all cause mortality up to a high number of cups. I'd imagine that the benefits are amplified if consumption is early in the day, as would be the case if someone compensated for not eating breakfast. The reason I think so is beacuse that would minimize detrimental effects on sleep
Smoking is increased due to it being a stimulant, so caffiene would be too. It would account for the worse sleep. But you have to remove the people that have bad outcomes from the study. They might as well remove the ones that have a increased risk of heart attack from the study too
Cigars!
Excellent video.
Great Video!
About skipping breakfast - what is breakfast? Is the breakfast time determined from the point of waking up, or is it circadian? By what markers can one determine that breakfast has been definitely skipped?
Depends how pedantic someone wants to be. Any one person can be outside the norm, but for the sake of generalising for a population we all know is meant as breakfast.
My guess is within a 'reasonable' amount of time after waking.
What people mean when they say 'skip breakfast' is they don't eat in the morning, when they may previously had done so. Skipping an AM meal is really just prolonging your fasted state.
So my apoB challenge is on the way. My baseline values . Triglycerides 86.8 mg/dL. Lp(a) roughly 25 nmol/L ( or 10 mg/dL there are some conversion troubles). Apo B is unfortunately 116 mg/dL, so I am starting rosuvastatin and ezetimibe therapy in a couple of days. I didn't measure LDL-c since we all know it's a dirty marker and apoB is way better. C reactive protein is less than 0.1 mg/dL which is really good. And I still do intermittent fasting and will continue to do so since it works for me.
I wish more people understood the depth it takes to effectively analyze runaway popular claims.
When I saw the news media go wild on this story, I knew this yt channel will get to it. :)
This is an excellent summary of what is common with the media hype of sensationalizing scanty or sketchy information. Like most such reports which are making mountains out of molehills, it is difficult to sort out facts from hyperbole explanations by novices for social media attention
Those that eat in a smaller window was very few only 400 out 20,000. Smaller groups have higher variations specifically when looking at rare events like heart attacks in these individuals in their 40s and 50s. Only looking at a few days through unreliable self reporting is ridiculous. Who knows what they ate or didn't eat for the many years after. Logically how can eating in a 12 hour or 8 hour window double your heart attack risk.
It promotes bad connections and choice is taken away. People that skip breakfast want to do something, but they can't, will start with one bad habit, ends with just bad habits.
Completely unrelated but I would be really keen to get your opinion on NOVOS. Any chance of a look at it?
Thanks.
The authors of the study achieved the results they expected. They got the media talking about them from a clickbait poster. Future will tell if anything comes out of it. Fortunately, we have sources like you on social media to keep the facts straight. Thank you.
Is it fair to say many poster are "clickbait"?
Thanks for this video as you really make sense of a lot of nonsense. Eating in a way that follows your circadian rhythm seems to have the best outcomes.
I would love a video explaining what “adjusting for X factor” exactly means. I don’t understand (and it’s because I just really don’t know) how you can adjust for bad sleep, or smoking etc.
I do IF for about 19 hours a day. Obviously skipping breakfast. 41, physically moderate active at work, no gym. Not eating in the morning means that I'm not sluggish. All the changes in my metabolism were for the better since starting IF, including blood pressure, blood glucose level, perfect BMI of 22.5 etc. The most important thing is what you eat when you do eat. For me that's a low carb diet, sometimes more keto, sometimes leaning towards mediterranean. But without any grains (inflammatory, gluten), legumes, seed oils. I do have extra virgin olive oil every day on my veggies and fish every other day. I don't do any calorie restriction, but fats and proteins are filling so IF is easy, no hunger. No junk foods, no sugars (mostly). According to my body fat scale all parameters are in excellent range for my age, sex and height. No alcohol, no smoking. My IF works wonders, due to some daily autophagy, but only because of high quality of nutrients when I do eat. 4 years and counting.
30K views and only 2K likes. People, show your apreciation :)
seems like an outlier compared to most other fasting studies where everything improves
From 1 night-owl to another: Eat "earlier in the day" as defined by daylight or wake-up time?
Please could you check for optimum amount to training weekly
I don't know about this study but I tried fasting for three days and I looked and felt horrible. I won't do it again.
There's one super important issue: People who are aware that they are in risk of heart disease will tend to do more fasting, because it's popular knowlege (regardless if it's true in reality or not) that it improves such issues. So you will have a selection bias.
Hey DR: You speak Spanish! Saw two Spanish books on your library!! "cirugia" and "Arte"
I almost knew this was going to be the subject this week and so glad it was. So many people who are very wedded to intermittant fasting or time restricted eating are going bananas over this, they think it is a personal attack on then. Even Satchin Panda on X was basically calling NHanes "Junk"! It's amazing how people get so committed to a diet or practice and if even the slightest preliminary criticism comes out, they feel physically attacked. They get defensive, insulting, etc. Even scientists who should know better. Pretty sad. I've done a lot of experimenting with eating windows and change things up with my schedule at least a few times per year to see how it affects me personally. I do think a lot of this can be individual, and it has to work with your schedule of course as well. But I agree that the content of the meals is the most important criteria, and that playing with meal timing is just a supplemental thing that can push things slightly in one direction or another for some people...
I love your voice bro
Hey doc, thanks for everything you do. What do you mean by "skipping breakfast"? Does it have to do with how long you delay eating after waking up and/or does refer to what you eat first? What is "breakfast" exactly? Thanks again
My mother in law was having one very large meal before bed and during the day eating or drinking only sweets , never called what she was consuming during the day as "food". She is obese.
Hehehe
Skipping breakfast leads to a higher rate of cardiovascular disease? Can you cite a source or link a video that you may have made on this topic please?
What about quality of diet? Might that affected results
A handful of seeds and nuts late at night actually have a positive impact on my sleep, heart rate and blood pressure. A handful, not a big bowl. Unsalted, no oil added, more generous on the pumpkin seeds side. But I personally find it challenging to eat enough calories, for various reasons, and this helps me pack some more calories, protein and good fats.
What about the claims that non-optimal sleep schedules contribute to disease and death, how well do those hold up under scrutiny? I've seen claims that e.g. oversleeping is related to depression, heart disease, neurodegenerative diseases, but always wondered how much of that is correlation vs causation. If someone has depression and MS, it's quite likely they may want or need to sleep more due to fatigue, but the extra sleep isn't causing the conditions by itself.
Talk tor Dr Longo at USC
Did they account for possible easting disorders? That potentially could explain or affect the group that was less than 8 hours...as soon as you said they had lower body mass, this was my first question
I wonder if they could change the questions asked. Ask them if they are intentionally or unintentionally fasting due to time constraints. That would be an interesting result
I personally never felt any benefit of it.
I’m on an OMAD diet and eat at 11am. I drink carbonated water with lemon when I wake up and a nettle tea. Walk everywhere. For my meal I first eat a portion of unpasteurised raw sauerkraut. Then about 1/2 hr later I will have either a grass fed beef steak or tinned wild pink salmon or pilchards (sardines), 2 eggs, some steamed broccoli/steamed kale, goats cheese, raw red onion, olives, some steamed beet. Afterwards I will put organic nuts and seeds (hemp, milled flax, walnuts, pecans, pumpkin seeds, soaked chia, Brazil nuts) in full fat Greek strained natural yogurt. I will also have 4 teaspoons of good quality evoo with a pinch of cayenne powder. That’s my meal. I take a vit d3+k2-mk-7, camu camu and vit b complex supplements. During the day I drink carbonated water with lemon, nettle teas. In the evening a couple of hrs before bed I will drink a camomile tea and take a magnesium bisglycinate+citrate, zinc citrate and a super strength omega 3 fish oil. I have lots of energy, feel good, no issues. So, how does this sound to you, any good?
Sounds quite solid to me.
@@Masterr59 thank you for taking the time to read and comment, appreciate it. I forgot to mention that I also take a capful of organic apple cider vinegar with every carbonated lemon water. Best wishes 🙏
I stopped animal products and lowered carb significantly; doing IF 14hr and more twice a week and never felt better.
I highly suspect it is the same result as breakfast skippers. Bad sleep, work stress, etc.
Hello Dr. Carvalho, could you make a video on how to measure calorie expenditure and make a healthy diet plan for a pre-diabetic? Nowadays, I loosing my weight like a hell, each week around 1 kg. Now my BMI became around 17.5 and I am felling sad. Three months ago I was diagnosed with pre-diabetic, and before that I have hypertension and health anxiety disorder, and I am 33 years old only 😢. By the I am doing intermittent fasting, shall I stop it? I am afraid to stop it.
Yes, it does sound like you should stop IF. You need to gain weight in a healthy way and develop a healthy relationship with food. There are professionals who can help with that. This sounds like orthorexia to me. Sorry, another thing to google. Hope you learn to take care of yourself.
Extraordinary claims require extraordinary proof. For most of evolution humans were naturally "fasting", not because it was fashionable but because there were no fridges and refined carbs. Would it not be reasonable to consider that selective pressure would weed out anyone not capable of dealing with intermittent food intake?
First sentence - totally agree. Second sentence - not necessarily imo. Average life-spans were much lower and in any case, if one survived long enough to procreate (young age) and see offspring into adolescence (also young) no problem, job done - there is no negative downside and no "evolutionary pressure" to behaviours which increase the slow build up of plaque in the arteries leading to heart-attacks/stroke etc many decades down the line. If on the other hand, intermittent fasting caused our ancestors to die out in say their teens and twenties then for sure you'd see an effect. A similar argument is made by some in the carnivore community who say "eating nothing but meat (and by extension loads of saturated fats) never did our ancestors any harm and what about evolution'.... etc). Same principle applies.
Extraordinary claims require extraordinary proof. Please prove that for most of evolution humans were naturally "fasting"
@@zak0n0 Have you ever wondered what "break-fast" means? Interestingly "dinner" means something similar. Here's more info on this: en.wikipedia.org/wiki/Dinner
Fasting due to necessity. Bit different when you are forcing it, when an icecream delivery is one phone call away. Our brain power is no better than those cavemen.
Not true. Just like apes, monkeys and other animals today, humans foraged from sun up to sun down.
Did they adjust for shift workers?
The researchers aren’t even watching what the subjects do - they are asking them what they did.
Hello Gil. With the ban on trans fats came processes such as interestification. But are interestified fats safe? From what I researched, there is no consensus. Thoughts?
Thanks for trying to nip the media hysteria in the bud. Really great to have a voice of reason out there. I totally relate to the night owl thing - I typically sleep 'til noon and go to sleep around 4AM. Been this way my whole life and was gratified when the medical powers that be decided to put a name to this condition - Delayed Sleep Phase Syndrome (DSPS). So now I know I'm not just doing it because I'm a lazy bum, lol.
Basically, if fasting works for you keep doing it! 😊
What qualifies as breakfast? I usually only eat 2 meals a day, sometimes 3. When I eat 2, the first one is often 3-4 hours after I wake up. I work out on average 2-3 times a week, usually prior to the first meal.
I'm not overweight, not stressed, don't smoke, never eat late and focus on good food quality. I don't feel worried about these headlines.
When I saw the media reports were based on a poster I just moved on.. As a working scientist, I pay very little attention to posters. If I'm at the meeting and chat to authors that I know well, and if I very much understand the methods, I may be more open. In any case, I am really skeptical on this one. If it's published, we'll see. One thing g I would need to know is WHY people are doing intermittent fasting, as opposed to, say, caloric reduction. Because people who intentionally do time restricted eating often lose weight.
I wonder how many intermittent fasting people are using stimulants.
What exactly does skipping breakfast mean? If I eat my first meal at 11am after having had my last meal at 6pm the night before, does that mean I'm skipping breakfast???
Professor Valter Longo always said he didn't like this 16:8 fasting and said we don't know the long term effects of this. He prefers 2-5 full days every month or two
I generally skip breakfast because I'm busy doing a minimum of one hour or more of cardio!
there are various reasons why spreding your meals more evenly is better. but i think that people with shorter feeding window (typically less meals) just have less variety in their food, eat faster and easily digesting food and avoid vegetable and fiber, maybe lack some micronutients etc. another big thing imho, there are some people which eat very bad and heavy meal in the evening, usually quite late and too close to bed time. these people are usually without morning apetite. question is, is it better to force feed yourself or let the body (and especially liver) rest and clear itself. i totally agree that total intake and quality of food are more important. i would add that digestion in general is very important. people with good digestion are fine. people with digestive issues can't digest and utilize food properly and it causes cascade of other issues. in this case some fast is good but just as cure to improve digestion, not as long term lifestyle.
IMHO, one other reason is that many people who use fasting do it either because they are overweight or they are fighting some disease. In other words, they aren't the healthiest in the first place. Also note that fasting is actually very stressful for the body. I used to follow a Facebook group who practiced dry fasting; it was crazy to see what these folds were embarking on , zero preparation, zero tampering, long fast, and dry fast are seriously taxing. Fasting is a powerful protocol, but like all powerful things, it does have its risks.
My sister started doing IF a while ago and lost weight and said she felt great. She is in her 70’s. But now she needed a pacemaker just recently. So I’m not surprised by these findings.
Your point ?
@@journeytoself8067 did you even watch the video?
@@journeytoself8067 she has heart disease is my point. Did you even watch the video.
You can fast and still eat unhealthy and get ❤ disease!
You can fast eat healthy and have longevity no ❤ disease !
27 years ago at age 43 I had severe heart attack followed by being diagnosed with heart failure and given 2 to 3 years to live then I adopted plants base diet with four hours of eating window ( 20 hours fast every day)and I swear to Allah I reversed my heart failure and at age 70 I have been the healthiest ever in my life.
Doesn't sound like much fun
@@brucejensen3081you’re really really stoopid
Now over 72 years old, I never go to ANY licensed medical practitioner fk em salve drivers, now barely any supplements bs, and intermittent and esp long term fasting is my medicine the past decade.
Plus exercise, like ashtanga yoga, high altitude hikes to 14k, and a blue zone based 120 gm protein diet, with home made no salt, no vinegar (uncooked) ferments.
Life before grasping the sugar demons by their horns, until they surrendered, was the toughest lesson ever.
These demons gave me crippling pain in the left hip, lower back and neck, asthma and fogged brain. Decades of it.
Never had a weight issue, but chronic inflammation. Serrapeptase to clean out and microcurrent biofeedback helped restore cellular voltages. 💖
I fast 18/6 or better and a 40 hour fast each week.
Just fast, its fastest bestest way to live way beyond 100.