Ep. 103 - Should I fast before surgery? | Does fasting help wound healing & diabetic ulcers? | Taking antibiotics or pain meds while fasting | Fasting effects on burns, angiogenesis, stem cells, & mTOR | Free Intermittent Fasting Plan for OMAD

In this episode, Dr. Scott and Tommy discuss how fasting can be used for optimal healing, surgical outcomes, and diabetic ulcers. Research findings and personal observations lead to pushing against the cutting edge of what is known about fasting's benefits. All of this can be applied by using your fasting and eating windows to create the best version of yourself.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7069085/

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Show Transcript: www.thefastingforlife.com/blog

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Fasting For Life Ep. 103.mp3

Dr. Scott Watier: [00:00:01] Hello. I'm Dr. Scott Watier

Tommy Welling: [00:00:03] And I'm Tommy Welling, and you're listening to the Fasting for Life podcast.

Dr. Scott Watier: [00:00:08] This podcast is about using fasting as a tool to regain your health. Achieve ultimate wellness and live the life you truly deserve.

Tommy Welling: [00:00:15] Each episode is a short conversation on a single topic with immediate, actionable steps. We cover everything from fat loss and health and wellness to the science of lifestyle design.

Dr. Scott Watier: [00:00:25] We started fasting for life because of how fasting has transformed our lives, and we hope to share the tools that we have learned

[00:00:30] Along the way.

Dr. Scott Watier: [00:00:40] Hey, everyone, welcome to the Fasting for Life podcast. My name is Dr. Scott Watier and I'm here, as always, am a good friend and colleague, Tomi Welling. Good afternoon to you, sir.

Tommy Welling: [00:00:48] Hey, Scott, how are you doing?

Dr. Scott Watier: [00:00:50] Fantastic, my friend. We are rocking and rolling in the thick of the holiday season. The last episode holiday hullabaloo got some really cool feedback and comments, and just people supporting one another on this fasting lifestyle journey. Yeah. And we're going to go into a little nerd mode today with a question that we get pretty often. And we have never addressed directly through doing some digging into some research articles and some studies and putting a different framework or thought process to this. It's something I've personally gone through, so we've shared some shared some stories and anecdotes, and we'll share some of that today as well. But really, it's around fasting and surgery, and there's so many thousands of. Hundreds of thousands of different types of surgeries out there that it's impossible to really hone in on one specific so we're going to go 30000 foot. We're going to talk about something very specifically related to blood sugar and diabetes and and wound healing and those types of things. But yeah, the question really stemmed from, Hey, is there a benefit to fasting in regards to healing and pre and post surgery?

Tommy Welling: [00:02:09] Yeah, because we like like we start to automatically start drawing conclusions when we're talking about optimizing blood pressure or cholesterol, blood work. Wait, you know, like all of these kind of things, sleep stress levels and you start to go like, OK, well, it seems like fasting can lead me to a healthier version of myself, like a healthier body. And then we start going like, OK, well, what if I need to go through surgery? Or what if? What if I? What if I got healthier before a surgery? Or what about an injury or anything else that might happen? Could could this have a more beneficial result at the end of the day? So that's kind of where the question came came from, and I think this is going to be a good conversation.

Dr. Scott Watier: [00:02:53] Yeah. So if you're new to the podcast and this is your first episode, don't don't worry if you are not prepping for a surgery and God forbid, you don't have to have one. Don't worry, there are going to be some. There's some nuanced fasting, lifestyle and intermittent fasting stuff built into here because we're going to break this down in pre surgery and post surgery recommendations. Medical disclaimer We are not surgeons. Talk to your doctor. Let them know your lifestyle. If you've been fasting and get clearance, of course, let them know what's going on. I know to your point, Tommy, that I did not think I was going to rupture my biceps tendon off of my forearm one day, moving a couch and have to have surgery. But I am very, very happy that I was, you know, 50 pounds less on no medications, had a healthy blood pressure, healthier weight and was not higher risk for that, you know, surgery that I ended up ultimately having to have unsuspecting. So thirty thousand foot view here. Let's stay consistent and and get to a healthier place because as we know, being at a healthier weight decreases the risk of complications during the surgeries, and we'll start with the pre surgery recommendations.

Dr. Scott Watier: [00:04:04] So if you're going into whatever surgical procedure you have, the study we're going to share about the benefits of 24 hour fasting is going to is going to relate to both of these situations. But we want to make this really clear all the recommendations of the surgery, right? Like, there are things put in place there to allow the anesthesia to be safe and effective, to allow you to come out of the surgery with the least amount of complications during or after. So there's a risk component to why the pre recommendations are the pre recommendations. So follow the pre recommendations and don't go rogue and do like a seven day fast leading up to a surgery. And even for me, when I had my my biceps tendon reattached, which was a major, it was a reconstructive surgery on my arm. They put in pins and screws and stuff. Mm hmm. They even told me like, Hey, make sure you stop taking your supplements because fish oil can screw with what we're going to do. So just a disclaimer. Talk to your doc, let them know, but follow those pre wrecks.

Tommy Welling: [00:05:07] Yeah, that reminds me of our conversation that we had about blood work, where those those blood work parameters are designed to, you know, they took into account a large sample population and then so like, you want to be between those goalposts, right? Like, you don't want to go rogue and you don't want to be the outlier in that situation where they're having to adjust things way outside of the norm because you went into it on this longer, fast or something like that, right? Like like put yourself in the middle of that, right?

Dr. Scott Watier: [00:05:35] Right now for the cholesterol, obviously, if you haven't listened to that episode, go back and listen to it because there are there is a change in theory that is moving towards removing that fasting component. But same same concept is in really looking at the pre and post thing as well, you know, so when you get similarly, when you get to the post-surgical, there's going to be certain limitations you have in terms of sticking with your fasting lifestyle, right? And that's going to be the medications, antibiotics, any type of, you know, pain medication that you might need. Like, I had a nerve block that wore off and they gave me some pain meds and I took it twice and I didn't like the way it made me feel. And I was like, Nope, I'm done with this and I. He gave me a 10 day antibiotic and I was like, Hey, I don't really like taking this stuff. Like, I didn't even have a pharmacy. Like, they're like, Where's your pharmacy? I'm like, I don't have, like, what do you mean? You don't have one? I'm like, I don't know, pick the closest one to my house. I don't know. Right? Yeah, yeah. I don't know. I haven't taken a medication in 15, 20 years, right? So I opted I was like, Hey, can you get me like a. Iv day antibiotics. That way, I don't have to worry about this whole like taking with food things. So really the same thing applies to the pre is the post like right out the gate post surgery is like, do what you need to do to follow the recommendations if there's any medical reason to do so like a medication.

Tommy Welling: [00:06:59] Yeah, I love the fact that you asked that question, though. Like like you push the boundaries just a little bit.

Dr. Scott Watier: [00:07:04] I was like, this guy. Like, Seriously? And this guy, I interviewed four different people and three different surgery centers, and we did regenerative medicine before they showed me up like I was. Yeah, he was all on board with it, thankfully, so I made the right choice and it was very successful. But yeah, I definitely, probably. Yeah, I was I might not have been the easiest pre surgical,

Tommy Welling: [00:07:23] You push the boundaries a little bit, but but then where did it get you? You had five less days of antibiotics and and frustration trying to like trying to do that and probably had a similar and result. So that's cool. And I think that's a good example. But then when you when you actually took those medications and some of them probably required food or their potentially harder on the stomach than others? And then what about what about between those times? Like, do you think that that you had to eat like like a full spread, like a like a large meal in order to to take those medicines?

Dr. Scott Watier: [00:07:57] Because I didn't want to because I know how that makes me feel so like I think really in this area, there's two things and you're alluding to one of them, which is the still, if you're an intermittent faster or you're a fasting for life, fasting, lifestyle, insulin friendly lifestyle person, then simply set a timer between those times and still stay intentional. So because what we do hear from some people and we've had some people from early on in the OG program from a couple of years ago when we first started, the podcast was like, Hey, let's see you guys. Then I had a surgery and I put on 40 pounds and I'm like, Yeah, OK, what happened? Like, the wheels just completely fell off, so staying intentional and still, even though it might be four or six hours. Set your timer. Stay in the rhythm of accountability and stay consistent.

Tommy Welling: [00:08:44] Yeah. Keep those boundaries. Keep the keep the lifestyle there, even if it's especially like if you were used to doing longer, fast, right? Like if you if you just had just crushed like 30 and 40 hour fast and from there. But then then you might you might think of it just right off the cuff as almost silly to set a timer for four or six hours. But the difference there between that versus like throwing the baby out with the bath water, so to speak, where the fasting lifestyle just goes out the window and then, you know, like, don't let that happen, right?

Dr. Scott Watier: [00:09:15] Yeah, for sure. Yeah, for sure. And if if I wouldn't, I just personally speaking, you know, I probably, you know, my activity was very limited for a couple of weeks and then I started, you know, I had to wait and even start doing physical therapy. And then all that was just mobility, right for the first, whatever, six weeks. But I'll share a couple anecdotally, a couple of cool things that happen. I know you have a story you want to share as well. So the second thing during this immediate and then we'll get into the research about the 24 hour fasting window and how powerful it truly is. And we just so happen to pick that as our free fast start guide on our way. It was the first thing we ever created other than turning the microphones on and posting a podcast. We're like, people need like help with that. So we'll talk about that in a little bit. But the second thing immediately post-surgery would be like, really focus on quality nutrition. And I know that might sound. Some of the stuff might sound silly, but like giving your body quality stuff to rebuild and heal like I couldn't have imagined eating pizza and wings, you know, post-surgery because I felt crappy already. So like, imagine like, I don't know, we kept it light. I ate light. But really giving your body nutrient dense, quality nutrition? I did. I did some green juice fast. After just some green juices that we made, I threw like an apple and celery, and my wife has kale in the house and kale and carrots, and I think I threw an orange in there one day. But like, just giving yourself nutrition is really key in the healing process as well.

Tommy Welling: [00:10:42] Yeah, so like like whole foods like like broad spectrum, nutritious good foods on the outskirts of the grocery store, right? So you're you're bringing in everything that you would need to to kind of heal during that time.

Dr. Scott Watier: [00:10:54] Right now, if you're flying solo and you got one arm, let's say which I did and you know, and you have to order food, just make conscious choices that you're trying to get as much quality in as you can, especially hydration as well. I use the ketones, not the ketones, excuse me, the the elements post-surgery as well, because that gave me something to look forward to to be able to like, stay hydrated. So yeah, really for the pre and post, that's, you know, the basic recommendations we get that we've gotten this question enough to make an entire episode around it. But what we want to do is take it a couple level levels, excuse me further and kind of apply it to the potential for one of the benefits. Additional benefits, excuse me, outside of let's say, most people come to fasting for weight loss and we're talking about healing here. There was a really cool study that showed the direct relationship to fasting before or after wound injury, and the wounds they were talking about were either through burns or diabetic neuropathy. So like diabetic ulcers. Right. So if you are, you know, coming to fasting with 20, 40, 50, 80, 100 pounds to lose, you've been on the diet roller coaster, the up and down I've lost. The same 30 or 40 or it used to be 30, now it's 40, now it's 50, you know, you're on your way, you're on the path to blood sugar related issues, prediabetes and diabetes. So I really love this study. The fasting before or after one injury accelerates wound healing through the activation of pro angiogenic, which is angiogenesis. We'll talk about that in a second through two specific pathways, and this was a a study done in mice. So we know there's limitations comparing it to humans, but this was like in 20 20. And it's really cool because at the end, when they did their literature review, they push the boundaries with relating what they saw in this study to some of the other non weight loss benefits of fasting.

Tommy Welling: [00:12:58] Yeah, that's a really cool thing because like happening in 2020, like we're pushing up against cutting edge research here where where it's it's only now recently being seen that there is some amazing healing potential here with what goes on within the body as as we start pushing into these fasts. And, you know, like there's just not a lot of of very specific granular research that's been done about each one of the little microbial microbiological processes that are actually happening here. So so this is really cool. And then, you know, we start to be able to connect the dots between what's been observed in other studies, like you mentioned.

Dr. Scott Watier: [00:13:42] Yeah. So just for the overview. And so in the introduction, they talk about healing of chronic diabetic ulcers in large burns is a very large clinical challenge in the in today's world of medicine, right? So I know you have a story you're going to share. Tell me a personal story that, you know, that is exactly what happened and then what's changed recently. But therapeutic fasting has been shown to improve overall health and their study tested specifically whether fasting facilitates healing in both the diabetic and burned burning, having burned wounds and explored like kind of the underlying mechanism. So they were looking at things like wound closure, re epithelial realization. So the regrowth of the the healthy tissue, scar formation, collagen deposition, skin cell proliferation and really importantly, the neo vascularization. So the new growth or the new input of healthy blood flow, which brings the oxygen and the nutrients to these areas. So they were doing the cool thing was they were looking at a time window that we typically talk a lot about, which is a twenty four hour fasting window. And they looked at different control groups versus different fasting groups and specifically about the diabetic ulcer group. Again, again in mice, right? So we understand that. But they looked at getting to 24 hour fast in a week post-surgery, but also pre-surgery was shown to have the best outcome, and it was pretty significant in terms of the healing process.

Tommy Welling: [00:15:28] Yeah, it was. And what I really thought was interesting here was the fact that we can we can induce these things like in a mice, in a mouse population. But these things like diabetic ulcers and these different wounds that kind of come about, they they can be like really unpredictable. They can they can last for a long time. They can stick with somebody for a while without really being able to to kind of get at at the issue itself, like my, my dad, for example, he had one of these where it was. It was classified as a diabetic ulcer and just stuck with him for a long, long time, like years and years and years. And even as he started to implement fast it, it kind of. It's still like ebbed and flowed. And but but it was always like, it's like he was kind of waiting for it to to kind of open up again, you know, like it didn't really have any good long term healing. But then recently, as he started getting pushing past 24 hours in, like actually started getting into thirty and thirty six hour fast, like all of a sudden, he he found like new connection points where it actually got to a point where it could it could heal in a way that he hadn't seen, you know, since since before he ever had the wound. So it's just

Dr. Scott Watier: [00:16:43] It's like, what changed there, Tommy? What was the biggest change that all of a sudden again, anecdotally speaking, but like, yeah, there's a connection here, right? Yeah.

Tommy Welling: [00:16:53] The biggest change for him was. It it's like it's like he was able to start staying more consistent with those twenty four to then 30 and then thirty six hour fast like he stacked a few of those on top of each other. Whereas, you know, previous to that, prior to that, he had been living in that probably 14 to 18 hour range very consistently. But and maintaining his his results or maintaining his weight for the most part. But but never consistently pushing past that point until just very recently.

Dr. Scott Watier: [00:17:29] So twenty four hour fasting window, right? Yeah. So if that that's why we love that window. Never mind does it create a deficit that allows you to see some improvements in your cravings and physiology balances out and you can you can get into some really significant fat burning and ketosis at that point. There's all those benefits. But yeah, it was cool to see that, you know, once that consistent 24 hour fast window was hit, the the skin right, the wound would heal more efficiently. And that's what this study shows. And it it wasn't just the fasting, it was the fasting combined with the re feeding, and it showed the best enhancement and endothelial angiogenesis. So that mouthful simply means angiogenesis means new growth. So angiogenesis of the blood vessels delivering nutrients and oxygen to those areas to allow them to heal. And so or neo vascularization, right? So when we had our neuropathy programs in the clinic, we would give supplementation and food recommendations to boost nitric oxide production and and the use of citrulline rather than arginine. And then, combined with the treatments in office and the therapies that we are using, we would see increase or revascularization of those areas, which would allow the diabetic neuropathy to heal. And we have patients come in with diabetic neuropathy, have had it for decades. And all of a sudden they're like, Doc, I can feel my foot and it hurts. And I'm like, Well, that's good. They're like, No, I don't want it to hurt. I don't know. Just give it a couple more weeks. That pain will go away. So the cool thing and this was before I knew about fasting, but fasting alone. Just those two 24 hour windows a week prior in a week post showed a huge improvement.

Tommy Welling: [00:19:23] I thought that was interesting and you just mentioned this the fact that the the fasting and then the re feeding ended up with a better outcome than just just the fasting. So that meant that you don't like to make it to make an interpretation of that, like the longer fast weren't weren't necessarily the answer to better healing in this in this model, this experimental model. But but the the fasting followed with the re feeding. It's almost like the fasting kind of prime the pump and allow the nutrients to be delivered and more angiotensin, more angiogenesis to to actually increase after after the feeding. I thought that was really interesting.

Dr. Scott Watier: [00:20:03] And both just for clarification. Both fasting groups did better than the control group, but the fasting group that had the specific feeding protocol was the best. And it really leads into the third part, I guess, of this. This conversation today, Tommy, was that what's the what's the translation to our day to day life like? What does this mean, right? So for me, I mean, we'll get to the action step here in a second. So I don't want to rehash that yet and give it away before we land the plane here. But the cool thing was that in their literature review and you had you had pulled this out and then I think there was a stat as well, Tommy, that you wanted to share. But since other benefits regarding cycles of fasting and refitting have been shown, such as promoting stem cell production. So this is in their review portion, right? And it's since other benefits regarding cycles of fasting and refitting have been shown, such as promoting stem cell production. And the two articles they reference are a prolonged fasting reduces IGF one to promote stem cell based regeneration and reverse immunosuppression in the gut. And then there's another one about mTOR and how that boost intestinal stem cell function related to the decrease in calorie intake. And then it talks about specifically the the the the the diabetic ulcer and reducing the glucose levels to allow those to heal. And then they reference the article about fast mimicking diet, promoting beta cell regeneration to reverse diabetes. And then they talk about inflammation associated skin lesions, which is cool because we've had people reach out to us and say, Hey, my skin tags are gone. Yeah, they just fell off. And that's another study about periodic diet that mimics fasting, promotes multisystem regeneration, enhance cognitive performance in health span. So we're talking about like. Really cool fasting benefits that are not, hey, I want to lose 20 pounds because I got a wedding coming up, but it was it was cool that that was part of this study in there in kind of there, like in their wrap up or takeaways.

Tommy Welling: [00:22:08] Yeah. And where some of the the ideation for for experimenting with this even came from was from recent results that were showing forty eight hour fast. So forty eight hour fast during during four day observation, augmented angiogenesis as well after ischemic brain injury. So and after after surgery. Whoa. Whoa. Yeah. Say that one more time. Yeah. So forty eight hour fast. After stroke and ischemic brain injury, also augmented angiogenesis, so improve new blood vessel formation and healing after brain injury, which was just incredible.

Dr. Scott Watier: [00:22:45] Wow. See, this is why I love man I love like because we obviously prepped for these episodes and we do research and we talk about, OK, what? What questions them come in. And we've gotten this question about surgery recently a few times, and then I just escaped having another second surgery on my right arm, and that's going to relate. Thankfully, that's going to relate to the takeaways here in a second. But I love like the fact that you said, Hey, I got this. You mentioned that to me. But then when you just set it live, I was like, Whoa, like. Like the fact that there's, you know, we talk about the twenty four to thirty six hour window increasing BDNF, which is brain derived and retrofit factor, which is like where we see people report to us that the brain fog goes away, right? Like, have this feeling, but you just related to like a very serious potential benefit post stroke or brain injury, where if in 48 hours of fasting for you guys that are listening that are new, you might be going, Oh, I can't even get past twenty two, right? Well. That's OK. Do a challenge, we'll get you there because it's one of the coolest things that we see is like, I never thought I could do 30 hours and not 30 hours or so easy. Now I want to do it. 48 Great. Cool. So awesome. But man, just some really cool, powerful, so like takeaway. So as we wrap up today's episode in like how does this apply to the general population, not just having someone that's about to have a surgery? I know for a fact you had your your dad's story, the people that tell us their skin's cleared up, they'll shun this before and after photos and they look younger.

Dr. Scott Watier: [00:24:12] Yeah, and the skin tags go away, right? But like, really, it's like, get started, stay consistent. Those are the two takeaways because I didn't think I was going to rupture my bicep. But again, I was really glad that I was no longer pre-diabetic and 50 pounds heavier. But I also didn't know I was going to partially tear my other one like almost to the exact year later in another freak accident when I was lifting something in a way that I shouldn't have been lifting it. Yeah. And I know for a fact that, you know, they kicked me out of rehab early. And when I went to see my doc 10 days after surgery and he looked at my, my wound and the scar, and he's like, Wow, this thing looks incredible. He's like, You might not have much of a visible scar at all. And I never put two and two together, and I know it's not, you know, a causes B, but I truly believe that there was some benefit there. So for everyone that's listening. Yeah. Don't you know if, God forbid, you have a freak accident, like let's be consistent with with with the ability to give our body the best opportunity to heal, which is part of something we talk about long term, which is the health benefits of the fasting lifestyle.

Tommy Welling: [00:25:17] Yeah. Like, you never know. I mean, you didn't you couldn't have predicted those things. You didn't know you were going to be in that situation, right? So whether it's like a wound or a surgery or anything else, it's like you could be in a position in a power position, you know, before that happens. So like being in the in the best health, the best A1C, the best, you know, fasting insulin levels like like all of those things like you get your you get the weight under control and you understand how to utilize a fasting lifestyle in a very powerful way. Like that's that's really cool. So I'm going to encourage everybody to to just get started. So you can you can you can get consistent, stay there and understand how to use this stuff for your benefit. And I think a cool place to start is going to be the fast start guide that you that you alluded to or you mentioned earlier, because just kind of getting past that like 12 or 14 or 16 hour window could make like it opens up your eyes to it, to a new world, a new way of doing things and and to be able to understand how to do that. Just just go download it at be fasting for life. Get the fast start guide. Get started. Find out how to put one meal a day, intermittent fasting into your day to day life. And, you know, just just apply some consistency to that, and you may be surprised at where it takes you.

Dr. Scott Watier: [00:26:36] Yeah, I love it. I love it. I love that there was some overlap there with the twenty four hour one meal a day, so we're just going to leave it at that time. And I love the conversation. Appreciate your time, as always, and for everybody listening. Thank you guys for being a loyal listeners, and we're going to continue to pump out episodes and content here and just grateful for all of you guys that hop on and listen to US Weekly. Keep sending us messages. Drop us a five star review. Head to the website. Check out the fast start guide, Tommy. Thank you, sir. We'll talk soon.

Tommy Welling: [00:27:03] Thank you. Bye. So you've heard today's episode, and you may be wondering, where do I start? Head on over to fasting for links and sign up for our newsletter, where you'll receive fasting tips and strategies to maximize results and fit fasting into your day to day life.

Dr. Scott Watier: [00:27:19] While are you there? Download your free fast start guide to get started today. Don't forget to subscribe on iTunes, Spotify or wherever you get your podcasts. Make sure to leave us a five star review and we'll be back next week with another episode of Fasting for Life.