In 2016 Dr. Ohsumi changed the fasting landscape when he won a Nobel prize for his work on autophagy. Autophagy is a process that helps your cells “take out the garbage”, removing damaged cells in order to generate newer, healthier cells. It’s something a healthy body does naturally, to promote healing and overall well being. 

So, what does autophagy have to do with fasting? 

Well, fasting is an effective way of triggering this magical autophagy process. Keep in mind, autophagy is different from ketosis, which is a fat burning state, while autophagy is a cellular detoxification, anti-aging and healing process. While fasting is one of the best ways to stimulate autophagy, there are a few other ways as well.

Ways to stimulate autophagy

• Autophagy fasting. This is a specific style of fasting that entails approximately 17 hours of fasting, a high fat, low carb diet and limited protein. See autophagy macros below.  
• HIIT training
• Hyperbaric oxygen therapy (HBOT)
• Red light therapy 
• Quality sleep
• Coffee 
• Cacao 
• Powerphenols like circumin, berberine, green tea and citrus bergamot found in Earl Grey tea

Autophagy fasting has so many benefits, yet it doesn’t require extended hours of fasting, which makes it a great foundational fast that everyone can do. 

Benefits of Autophagy

• Enhanced immune function and immune strength (while autophagy dysfunction downregulates your immune system)
• Creation of new, healthy cells
• Increased detection and clearing infections, pathogens, viruses, bacteria
• Removing toxic proteins from cells
• Help regulating a cytokine storm 
• Improved cognitive function
• More energy to mitochondria
• Protecting the nervous system

The effect of fasting and autophagy on immune health is best scribed by this study: “As a healthy practice, calorie restriction in the form of intermittent fasting (IF) in several clinical settings has been reported to promote several health benefits, including priming of the immune response. This dietary restriction also activates autophagy, a cell surveillance system that boosts up immunity. With these prevailing significance in priming host defense, IF could be a potential strategy amid this outbreak to fighting off SARS-CoV-2 infection.”

Autophagy Basics

Autophagy fasting entails fasting for approximately 17 hours, we’ve determined this to be the “sweet spot” of autophagy, although there is evidence that autophagy is turned on between 17-72 hours of fasting. Think of autophagy like a dimmer switch, increasing gradually the longer you fast. 

Autophagy fasting is unique from other forms of fasting in that you will break your fast with good, healthy fats like avocado, MCT oil, grass fed ghee or butter. Then you will wait at least one (1) hour before opening up your eating window. 

When you open your eating window, you’ll want to follow the Autophagy macros, which is:

• 50 grams of net carbs
• Under 20 grams of protein
• One serving (1-2 TB) of good fats with meals

It’s important to note that eating good fats should not spike your blood sugar. You’ll find that blood sugar will stay level and may even drop. This means that even though you are no longer in a fasted state, you’re still technically in a state of autophagy. 

When it comes to your eating window, as long as you keep your protein under 20 grams, technically you should still be staying in a continuous autophagy-like state. 

How to measure autophagy 

There are a few ways to measure autophagy. The first is with a blood test, called an autophagic flux. The second way of determining autophagy is using the Glucose Ketone Index, as used by KetoMojo. The GKI is a formula that tracks the ratio of blood glucose to ketones as a single value. What you will do is divide your glucose reading by 18, then divide that number by your ketone reading. 

For example, if your blood sugar is 90 mg/DL, you’ll divide that by 18, then divide that by 1.0 mmol, to get a GKI of 5. 

Glucose Ketone Index

<1: Therapeutic ketosis. This is the highest state of ketosis and autophagy and is difficult to attain without longer fasting. 

1-3: High ketosis and autophagy.This is a therapeutic range for things like cancer, epilepsy, Alzheimers or Parkinson’s disease, diabetes or chronic inflammatory disease.

3-6:  Functional ketosis. This is moderate ketosis and autophagy. This is where most people will want to be. It’s ideal for weight loss, insulin resistance, metabolic or endocrine disorders. 

6-9: Low levels of ketosis and autophagy. This is great for low to moderate weight loss and overall health maintenance.

The third way to measure autophagy is using Dr. Annette Bosworth, aka Dr. Boz’s autophagy calculation, where you divide glucose by ketones. For example if your blood sugar reading was 85 mg and your ketones were 1.5 mmol, you would get 56, which according to her scale would fall into a low level of autophagy. 

Dr. Boz’s scale

Below 80: low level of autophagy 

Below 40: solid chance of autophagy 

Below 20: best chance of autophagy 

The questions I often get is, if autophagy is so great, how often should I be doing it? That depends on a couple of considerations. First, what are your goals? If you need more muscle growth, then you might want to look at protein cycling and carnivore fasting where you are stimulating something called MTor. However if your intention is repairing muscles or getting into a mode of healing, the autophagy is the fast you want. 

The second thing to ask yourself is, do you need a detox? If the answer is yes, then autophagy is your fast. Autophagy will help detect and remove viruses, bacteria and promote regeneration on a cellular level. However be aware that autophagy will not detox heavy metals, synthetic chemicals, glyphosate, plastics, etc.