The Fear of Fasting

Old people are not big eaters.

It’s a challenge in our assisted living homes to convince a lot of our residents to eat. There are many reasons for this:

• Our metabolism slows down as we age

• Changes in the ability to taste and smell makes food less appealing

• Dental problems

• Difficulty swallowing

• Digestion slows so we can feel more full than we are

We’ve seen our share of sub-100lb residents - especially the little old ladies.

In an effort to fight this, the Department of Health in many locations highly encourage people to eat multiple times a day. Here is an example from the Department of Health in my state, Arizona:

The trouble with the little old ladies is that they often move into our assisted living homes from their homes. If left unsupervised, they will avoid eating. What they do eat is often junk.

We have the opposite problem when people move their Mom or Dad from another facility to ours. The other facility wants to stay in compliance with the Department of Health. So they feed their residents all day long. Lots of meals and snacks.

Lots of calories and carbs as well.

Their families often tell us how their Mom and Dad really ‘ballooned’ up in the previous facility.

And their overall health declined.

We take a different approach. We work with our doctor and health coach to see what the resident needs. For the ones with cognitive decline, we feed them very low-carb ketogenic or carnivore meals. We mostly will serve them three meals a day, but we try to do it in a tight window so they have 14-16 hours between dinner and breakfast the next morning.

We try to avoid snacks. If they really want snacks, we serve beef jerky, meat sticks, or pork rinds.

Recently I talked to a family about trying an extended fast with one resident. I talked to the resident’s doctor who was on board with it as well. They have been avoiding my discussion with them for about 8 months.

Then they finally agreed to it after months of showing them the ketone levels of their loved one were not going up significantly on the carnivore diet. The resident’s blood sugar levels were not improving a lot either.

Not horrible, but not great.

They agreed to a 3 day fast. Here are the ketone and blood sugar readings before the fast, at 48 hours, and at 72 hours where we stopped the fast.

At the end of the fast, the resident seemed a lot more alert and was talking more as well. They are regularly non-verbal.

The only time the resident seemed upset was his last skin prick to check his blood sugar and ketones.

The family loved the results. They want to make it a monthly ritual.

It’s important to assess the health condition of each individual before undergoing a fast. It may not be a good idea for those 90lb ladies. But we should not rule out fasting and lay down blanket regulations for an entire population either.

Because fasting can be a powerful tool in the fight against cognitive decline.