Autophagy - An amateur guide - Part 2

Disclaimer: I am not a doctor and none of this is medical advice. I am just someone who has a deep enduring interest in improving mine (and hopefully other's) physical, spiritual and mental well being. I research on my own and whatever I learn, I evaluate and implement in my own life to serve as proof that things do get better if we take action. Sunchase.

In the last post we saw how autophagy can be a gamechanger for our health with benefits ranging from preventing Alzheimer's to protecting our DNA. So how does one get in on the action? Well that is what we are going to cover in this post.

A quick recap first though, autophagy is when our body recycles damaged components within our cells and uses that to repair cells in need of repair. Hence having the double benefit of removing cellular waste that accumulates within our bodies while repairing cells and thus improving overall health. Autophagy is triggered when a certain complex in our bodies, called mTOR, is turned down. Our bodies essentially have two "modes" - "growth mode" or "repair mode". Autophagy is "repair mode".

How do I get to a state of autophagy?

Simple, when we do not eat for 16-24 hours (on average) our body's reserve of glucose (the thing that our cells convert into energy) depletes and it starts doing two things - starts burning fat for fuel (called ketosis) and starts breaking down damaged cells/their components for use in healthy cells (autophagy).

But as I said in the last post, autophagy starts off as something known as "hormetic stress" - mild stress that actually benefits us, think of how working out at the gym makes our muscles sore for a few hours but strong in the days and weeks that follow, it's like that. Of course it does not take much for hormetic stress to become real stress that can be harmful, obviously prolonged lack of food (i.e. starvation) leads to death. So a more relevant question here would be - How can I get into an optimal state of autophagy that I can maintain over the long term?

The answer to this question is a bit more complicated than keeping a day's fast.

How do I get to an optimal state of autophagy?

As food was never plentiful in our hunter-gatherer days, our bodies naturally evolved to cycle between "repair" and "growth modes" i.e. in and out of autophagy. In today's era, the abundance of food (especially of unhealthy high glycemic index variety) combined with our lifestyles and maybe a general lack of awareness about healthy living means that we keep our bodies always in the growth mode.

What you want to do is cycle between "growth" and "repair" modes as we naturally evolved to do.

According to the book "The Switch" by James Clement, anyone above 25 should start introducing autophagy in their lives and thus be in "repair mode" for some time every year. According to Clement, one should dial up autophagy (known as a catabolic state) for 8 months and be in "growth mode" (a.k.a. anabolic state) for 4 months. This ratio of 2:1 between being in "repair mode" by dialing up autophagy and "growth mode" can be applied in shorter durations of 2 months:1 month or 2 weeks:1 week as well.

The key here is to be able to sustain autophagy, hence during the "repair" months one needs to be really deliberate about what they put in their mouths and eating the wrong things the wrong way can kick your body out of autophagy. Again, according to "The Switch", one should stick to a high fibre, high fat, moderate protein and low carb diet to be able to sustain the "repair" months.

One should stick to a high fibre, high fat, moderate protein and low carb diet for 8 months in a year

Why? Because the primary means of turning on autophagy is by blocking the effect that insulin has on keeping mTOR activated and cells stuck in “growth” mode. Where do you get insulin from? Carbs (and also too much protein).

The Autophagic Life

When do you actually start to transition into autophagy as a lifestyle is a matter of personal choice, though I'd say that it should be sooner than later. At any rate it makes sense to at least know how to make the switch should you decide to do it and you can always pick and choose the parts you can do.

Here are a few tips on how we can sustainably switch between autophagy and "growth" mode, I've divided them into sections on diet, supplementation, exercise and sleep. I'll also briefly talk about how one can measure that their health is actually improving because of all this. Again, all of this information comes from "The Switch" which goes into much more depth on the topic, I'd recommended reading it if you're really serious about using autophagy to improve health.

Diet

1. First and foremost, start eating 80% to satiety - that is, stop eating when you feel the peckish need to have a few more pieces. This is also conjectured to be one of the reasons why the Okinawans live the longest
2. Limit your eating window to 8 hours per day i.e. practice intermittent fasting. Also work your way up to doing 3 day fasts once a quarter - this really flushes your system clean and is not that hard to do once your body gets used to relying on fat for fuel (ketosis)
3. A high fibre, high fat, moderate protein and low carb diet means the following in terms of actual food:
1. Remove refined carbs and sugars from your life entirely
2. Dramatically reduce consumption of whole grain foods - though better than foods with refined carbs, too much of these will also prevent you from entering autophagy
3. Dramatically reduce consumption of meat, poultry, eggs and dairy - protein should be 
4. Dial up the consumption of high GI (glycemic index) vegetables: How long it takes for something to get digested - the longer it takes, the longer you feel full, the better it is for inducing autophagy. Also, "Eat the rainbow" increase the variety of the vegetables you eat
5. Eat things that are seasonal and not preserved through freezing or some other way
6. Use oils high in MUFA like olive and rapeseed oil - A rule of thumb is that if a fat remains liquid in winter then its good, while fats that solidify in winters are not good (e.g. butter, ghee etc.)
4. Basically you want your body to rely on fat more than carbs, hence be in ketosis. While keeping around enough protein to support muscle growth and repair when needed

Supplementation

1. Fish oil
2. Multivitamins (the jury is still out on this one, but vitamin B and D supplements are often advised)
3. Caffeine (though coffee), green tea, ginger consumption can be increased during autophagy phase

Exercise

1. First engage in aerobic physical activity (like cycling, running, swimming etc.) for at least twenty minutes per day if you're not already doing so
2. Next start strength training (i.e. workouts with weights) becomes increasingly important as we grow older to ensure that body strength and stability is maintained - At least 5 days a week
3. Include at least 2 days of HIIT in your workout regime

Sleep

Poor quality sleep interferes with autophagy (apart from leaving us groggy in the morning), practice the following to ensure you get your forty winks:

1. Early to bed and early to rise + having a consistent sleep schedule really works wonders for autophagy
2. Avoid having anything high in caffeine 3-4 hours before sleeping
3. Minimize distractions while sleeping - keep your bedroom clear of phones, tablets, unpaid bills etc.

Measuring how you're doing

Being metabolically healthy means having optimal levels of the following without the use of drugs:

1. Waist circumference
2. Blood pressure
3. Blood glucose
4. Triglycerides (blood fats)
5. High density lipoproteins (a.k.a. good cholesterol)

A quick Google search will reveal ideal levels for your age, gender and so on. Start measuring and recording these (an Excel sheet if you will) every day (pt. 1, 2, 3)/every 3 months (pt. 4, 5) as a general habit, and if the readings start to go out of sync of ideal levels then you'll know something is off. Measuring point 1 is super easy, you just need measuring tape, while points 2 and 3 are relatively easy too as there are quite a few affordable machines in the market that you can buy to measure those. Point 4 and 5 are measured via a blood test that is done in hospitals and can be done as part of your regular health check up.

More resources

I found the following books to be great resources on learning how to practice autophagy and related techniques that can be a compliment to it (such as intermittent fasting):

The Switch by James Clement

Metabolic Autophagy by Siim Land

The Scientific Approach to Intermittent Fasting by Michael Vanderschelden

Final thoughts

For something to make sense to a layman like me it should be really commonsensical - and autophagy with its evolutionary history does make sense to me - if for 99% of human history our bodies were using it to survive then I get how messing with it is probably not a good idea.

Autophagy is being backed by science and there are quite a few different unrelated places (books, podcasts, research papers, articles) where I have seen it pop up and get discussed in the same "this can really be the silver bullet" kind of way.

When trying it out for myself, while the pain of leaving my favorite foods is real, but the energy and lightness I feel is worth it. I'm going to keep practicing autophagy as a part of my lifestyle to keep my health switched on.