~Fasting and Calorie Restriction

~Fasting and Calorie Restriction
Reprinted with permission of Life Extension®.

With Dietary and Supplemental Suggestions to Increase Life Span

  • Fasting
  • CRON (Caloric Restriction with Optimal Nutrition)
Fasting
  • Health Begins At the Cellular Level
  • Autotoxicity
  • Fasting Addresses Cellular Toxicity
  • Fasting To Lose Weight
  • Preventive and Therapeutic Objectives
  • The Best Way to Fast
  • Adjuvants to a Successful Cleanse
  • Recommended Liquid Intake while Fasting
  • Food Transitioning On and Off a Fast
  • Medications and Nutritional Supplements
  • Is Fasting Safe?
  • Seldom Are Scientific Opinions Undisputed
Benjamin Franklin appears to have had not only a grasp concerning the needs of his generation but also a vision for the future when he challenged that the best of all medicines are not potions or drugs but rather rest and fasting (fasting addresses the cause of the illness, whereas drugs are often directed toward the symptoms that accompany the condition).

The early church recognized fasting as a means of obtaining force in spiritual pleas, while at the same time enhancing physical health (Wallis 1993). Throughout history, reports of the merits of fasting have inspired a subset of the population to engage in the ritual, however, the United States is still far behind the learning curve. European clinics have (for decades) successfully used fasting for detoxification and healing purposes. Joel Fuhrman, M.D., in his book Fasting and Eating For Health reported that the time may come when a physician who does not recommend fasting as an effective nutritional approach will be guilty of malpractice (Fuhrman 1998).

A fast can take various forms. For example, a faster can abstain from specific foods such as meat or sugar, fast from dawn to dusk, fast one meal per day, fast one-day per week, totally withdraw from all foods, or fast only on juices and broths. Juice fasting, considered much safer than total food abstinence, requires instruction to be successful and is the primary focus of this protocol.

It is important to note that a recent report showed that the health benefits of sharply cutting calories (as occurs with periodic fasting) accrue even if the fast does not result in eating less overall. Benefits ranging from longer life to less stress and greater sensitivity to insulin have been reported. The Proceedings of the National Academy of Sciences reported that mice that were fed every other day but were allowed to gorge themselves on the days they were permitted food had similar health benefits to ones on a diet reduced by 40% of normal food intake (The Associated Press 2003).

Mark Mattson at The National Institute on Aging says a study is being planned to test the effect of similar fasting patterns on people. The plan is to compare the health of a group of people fed the normal three meals a day with a similar group, eating the same diet and amount of food, but consuming it within 4 hours and then fasting for 20 hours before eating again. Mattson believes that skipping meals will not result in any injurious effects to the subjects. In fact, fasting aficionados believe that by fasting three days a month you will heal faster and may extend your life several years (a three-day fast helps rid the body of toxins, and a five-day fast is thought to start the healing process) (Healing Celebrations 2002; The Associated Press 2003).

Although fasting is often touted as one of the oldest and surest modalities to establish good health (promoting internal cleansing and healing, normalizing blood pressure and cholesterol, rebuilding the immune system, and reversing the aging process), it is not without its critics. Because The Life Extension Foundation is committed to improving the health of the public and increasing life span, both sides of the fasting issue will be thoroughly presented.

Health Begins At the Cellular Level

There are more than 200 different cell types and a debatable number of cells in the entire body (some sources estimate about 50 trillion cells are contained in the human structure but others calculate the number may be nearer 100 trillion). We are aware that the number of cells in the body is not static; as cells die or are destroyed and new ones are formed, the cell numbers are constantly changing. It has been estimated that about one-half of all body cells are in the peak of development and working condition at one time; one-fourth are usually in the process of growth; and the other fourth are in the process of dying and replacement.

Natural hygienists believe that the one cause of all disease is toxic saturation at the cellular level. Every function that the cell performs produces waste products (poisonous materials that are incompatible with cellular health). The cells have elimination capacities for ridding toxins but these pathways can become so saturated that the systems become bogged down. If the body becomes overwhelmed, it will attempt to rid the toxins through other escape mechanisms, for example colds, catarrh, inflammation, and skin eruptions. Toxemia has, in fact, been described as nature's effort to eliminate toxins.

It should be emphasized that the body appears fully capable of healing if the infarctions are stopped and proper nutrients are provided; conversely, there appears a clear connection between the consequences of a toxic internal environment and the development of a number of debilitating health conditions. In fact, it is believed that biochemical suffocation (the interference with normal cell metabolism and cell regeneration) is the principle cause of disease and aging. Hans Selye, a Canadian physician/endocrinologist with many honorary degrees for his scientific contributions, believed that life, the biological chain that holds our parts together, is only as strong as the weakest vital link, the cell.

Since toxic waste products interfere with the functioning of the cell, it is important that both toxins and dying cells are eliminated from the system as efficiently as possible. Quick and effective elimination of infirmed or dead cells stimulates the building and growth of a generation of more functional cells. As Michael Rosenbaum, M.D., Director of the California-based Orthomolecular Health Medicine Medical Society states, "As your cells go, so goes your health. Cleanse and nourish your cells, and you're on the road to better health" (Airola 1977; FCI 2002; Nison 2003).

Autotoxicity (Self-Poisoning)

Cellular deceleration appears caused by the accumulation of waste products in the tissues, which interferes with the nourishment and oxygenation of the cell. When dietary deficiencies, sluggish metabolism, sedentary lifestyle, lack of fresh air and water, overeating, and consequent poor digestion and assimilation cause the cells to become deprived, they start to degenerate and break down (Airola 1977). Subsequently, the body ages from the "inside out," becoming vulnerable to disease and the unwanted signs of senescence. Proponents of fasting declare that aging is not commensurate with calendar years but rather with the health of the cells.

As toxins build up in body tissues, a toxic (potentially lethal) environment is created. It is not uncommon for symptoms of headache, diarrhea, or depression to occur as the body deals with autotoxicity (self-poisoning). During fasting, the concentration of toxins expunged from the body and appearing in the urine can increase ten times above normal concentrations.

A Fast Addresses Cellular Toxicity

According to Evart Loomis, M.D., fasting triggers a truly wondrous cleansing process that reaches down to every cell and tissue in the body (accelerating the elimination of dead and dying cells and stimulating the building of new cells). During the fast, toxic waste products that interfere with the nourishment of the cells are effectively eliminated and normal metabolic rate as well as cellular oxygenation is restored.

A fast grants a respite from the energy-demanding efforts of digestion (10% of daily caloric intake is used for mastication, digestion, assimilation, and elimination). Instead, energy can be redirected toward improved immune function, cell growth, and eliminatory processes.

Within 24 hours of food restriction, enzymes stop entering the stomach and travel instead into the intestines and bloodstream, where they circulate and gorge on waste materials (toxic aftermaths of daily living). Advocates of fasting believe that the body will first decompose and burn those cells and tissues which are diseased, damaged, or aged, e.g., dead cells and morbid accumulations (tumors, abscesses, and fatty deposits). Dr. Otto Buchinger, M.D., (perhaps the most renowned advocate of fasting) referred to fasting as a refuse disposal or a means of burning the rubbish (Saxion 2002). It is important to note that essential tissues and vital organs, as well as the nervous system and the brain are not damaged during a well-planned fast.

On the other hand, starvation can have serious effects on all major body systems and organs. Initially, the basic metabolic response to starvation is to conserve vital tissues as well as energy. In time, the body will be forced (as a survival maneuver) to use essential tissue for energy, including muscles and organs. The liver and intestines typically lose the highest percentage of their own weight during starvation, followed by the heart and kidneys. Because heart size may be reduced, the individual may experience low blood pressure and a slowed pulse. Total starvation is usually fatal in 8 to 12 weeks; long-term dehydration can ultimately lead to kidney failure (Merck Manual of Medical Information, Home Edition; Pale Reflections 1998).

Fasting To Lose Weight

Fully half of all individuals do not undertake a fast to lose weight. Rather the impetus is to regain lost energy, heighten clarity of consciousness, enhance innate spirituality, or to cleanse, rest, regenerate, and rejuvenate the body. Nonetheless, a weight loss should be expected. On a prolonged fast, about 5-7 pounds of fecal material may be lost from the colon, but this amount is regained upon re-feeding. It is also not uncommon to detoxify 5-to10 pounds of toxic chemicals (FCI 2003). Comment: Although a short fast (three to five days) may not accomplish your full intent, it is (by far) the safest recommendation. It has taken years to wear the body down, and it will take time to restore it to its' peak condition. Recall that a short fast can be repeated several times a year to optimize the benefits. However, it appears best (even if undergoing an abbreviated fast) to consult with your physician to determine if extenuating health concerns would preclude a fast. If you are under the watchful tutelage of an experienced health care provider, a longer fast may be considered.

Preventive and Therapeutic Objectives

Dr. Buchinger believed that preventive fasting reduced the effects of potentially dangerous risk factors (hypertension, cigarette smoking, obesity, elevated uric acid and blood lipids, as well as a sedentary lifestyle). Therapeutically, a fast has proven effective against the following conditions (Fuhrman 1998; AFL 2000; FCI 2002).
  • Cardiovascular diseases, including circulatory disturbances and prevention of a myocardial infarction (heart attack) and its after-care
  • Migraines and glaucoma
  • Disorders of the stomach and intestines, bulimia, and chronic constipation
  • Diseases of the liver and biliary tract
  • Crohn' s disease and ulcerative colitis
  • Diseases affecting locomotion (rheumatism, joint and vertebral degeneration, and problems involving muscles and tendons)
  • Skin diseases (allergies, psoriasis, and chronic eczemas)
  • Diseases of the upper respiratory tract (nose, nasal cavity, ethmoidal air cells, sinuses, larynx, and trachea)
  • Fibroid tumors, nasal polyps, lipomas, benign ovarian and breast tumors
  • Lagging libido
  • Post treatment for malignant disease. The residues of a necrotic (dead) mass can be highly toxic (even lethal) to the patient. However, a fast does more than detoxify the noxious by-products of the malignancy; it also breaks down abnormal cells and tumors, releasing diseased tissues and their cellular products into the circulation for elimination.
The Proceedings of the National Academy of Sciences (2003) showed that mice that were fed every other day had more protection from diabetes and Alzheimer's disease than mice eating low-calorie or unrestricted diets. For example, one group of mice fasted for a day, then the next day they were allowed to eat ad libitum (Latin: at pleasure). This group of mice ended up eating the same amount of calories as the second group of mice (those allowed to eat as much as they wanted every day). A third group of mice was fed a low-calorie diet each day, consuming 40% fewer calories than the other two groups.

After five months, researchers gave the mice a neurotoxin that damages nerve cells similarly to Alzheimer's disease. Mice that fasted had fewer damaged nerve cells in the brain than mice that ate unrestricted or a low-calorie diet. In addition, blood tests showed that the fasted mice had lower insulin levels than the other mice, which implies a lower risk of developing diabetes (Mercola 2003a).

In 1972, Dr. Yuri Nikolayev, director of the fasting unit at the Moscow Psychiatric Institute, reported on the use of fasting to successfully treat over 6000 patients, all suffering from neuropsychiatric disorders such as schizophrenia and various neuroses. Irrefutable studies showed that 70% of the patients improved on the fasting regimen. Dr. Nikolayev said, "The hunger treatment gives the entire nervous system and the brain a rest. The body is cleansed of poisons, and the tissues and the various glands are renovated. Resting the brain forms the basis for the treatment of various neuropsychiatric disorders. Treatment through fasting is an internal operation, without a scalpel" (FCI 2002). Japanese researchers reached similar conclusions. After fasting 382 patients (all suffering psychosomatic disease) an 87% success rate was noted (Christian Century 1977; AFL 2000).

The Best Way to Fast

A number of authorities agree that juice fasting is the best, safest, and most effective method of fasting. The classic form of fasting (an extended pure water fast) "dumps" considerable toxins into the bloodstream and has for the past 75 years been discredited as the premier form of fasting. This extremely taxing form of fasting can be so debilitating that bed rest is often the only alternative as the body is forced to deal with severe physical and emotional stresses.

When fresh fruit and vegetable juices, alkalizing vegetable broths, and herbal teas are used, the system is biochemically balanced and electrolytes are maintained. The faster receives a daily infusion of vitamins, minerals, and enzymes. In addition, the freshly prepared juices require no digestion and are easily assimilated directly into the bloodstream. Subsequently, juices do not disrupt the healing and rejuvenating process of autolysis (self-digestion). By providing about 400 calories per day (through easily absorbed juices and broths) the release of toxins from fat cells is much more gradual than that experienced during a water fast.

Do not chew gum while fasting. Chewing gum promotes the outflow of digestive enzymes; during a fast, the stomach is void of solid foods and subsequently, the enzymes can have an injurious effect upon the stomach lining. Also, avoid mints and hard candies. Following the fast, individuals often report losing their appetite for caffeine, nicotine, alcohol, sugar, and junk foods (addictives that are "off limits" during the course of the fast).

Typically, a well-planned fast allows the subject to continue with their normal workload, as well as exercise and study habits. During a fast, your body needs motion in the form of walking and deep-breathing exercises as well as fresh air to accomplish a thorough cleansing of the blood and tissues and to effectively regenerate and revitalize body functions. However, it is equally important to get adequate amounts of rest. If feeling fatigued, do not hesitate to take a break. For this reason, some fasters prefer a weekend fast, when the schedule is less demanding.

Adjuvants to a Successful Cleanse

Since a fast does not always provide sufficient elimination factors to remove impacted waste materials from the colon, a plan for colon cleansing should be implemented. Fasters often rely upon colonics and herbal laxatives (such as senna); others use a psyllium powder as a bulking agent. Enemas (containing 1 pint to 1 quart of water) are valuable additions to a successful cleanse and should be taken at least once, preferably twice a day (upon arising and before going to bed) (Horowitz 2001). Fasting without the aid of enemas allows toxins to remain in the colon and to be reabsorbed into the system. This sequence has the potential of poisoning the body. The eliminative organs (particularly the kidneys) will try to pick up the burden, but the toxic overload may prove too extreme and result in organ damage (Airola 1977).

Dry brush massage (morning and evening) is a helpful adjunct to detoxification (more than one pound of waste products is discharged through the skin every day). Purchase a natural bristle brush (about the size of your hand) with a long handle attached. Avoid nylon or synthetic fiber brushes because the sharpness of unnatural bristles can damage the skin.

Brush the entire body excepting the face. First brush the feet and legs, then the hands and arms and lastly the back, abdomen, chest and neck (Airola 1977). Brush for at least three minutes, producing a warm, glowing hue. Do not brush aggressively to avoid damaging the skin. Remember to always brush toward the heart. The reason for this is that all lymph vessels have one-way valves, which open in the direction of the heart and eventually empty into the large blood vessels leading to the heart.

After brushing, take a shower (preferably a hot shower, about 3 minutes in duration, followed by a 10 to 20 second cold rinse). Alternate this procedure about three times. If the hot/cold showers are too extreme for the subject, a warm shower (only) should be used. Follow the shower with a rubdown with either a sponge or towel to remove dead skin particles. Comment: The cleansing process is performed by a number of organs, glands, and transportation systems, including the alimentary canal, kidneys, liver, lungs, lymphatic system, and mucous membranes; however, the skin is regarded as the largest eliminative organ. It is estimated that one-third of all body impurities are removed through the skin's tiny sweat glands, earning it the reputation of being "the third kidney." Historically, sweating has been documented as an effective means of purification. Sylvius (the famous seventeenth-century Dutch physician) believed that about one-third of all diseases could be cured by sweating.

Recommended Liquid Intake while Fasting

Opinions vary on the amount of liquid to consume while juice fasting. Dr. James F. Balch recommends consuming at least eight 8-ounce glasses of steam-distilled water a day, plus 2 cups of herbal tea, along with juices (dilute all juices with water, adding 1 part water to 3 parts juice). Many physicians suggest steam-distilled water while fasting because it assists in pulling toxins from the system. Comment: Regardless as to your fitness goal, make sure you are drinking sufficient amounts of water on a daily basis. Many ailments classified as "diseases" respond beautifully to adequate hydration, flushing out disease-provoking toxins from the system. Mayo Clinic offers an easy formula for calculating your bodies' daily water requirements; take your weight and divide it in half. If, for example, you weigh 150 pounds, you need 75 ounces (9-10 glasses) daily. Caffeinated and alcoholic beverages are actually dehydrating so for every glass of these beverages you drink, you need to add an extra glass of water (Airola 1977; Balch 1997; Woman's World 2001; Horowitz 2002).

Drink freshly prepared juice made from a combination of any of the following (organic when available) fruits and vegetables: spinach, dandelion, parsley, kale, celery, apples (with seeds and skin), and carrots. Dr. N.W. Walker, who lived to be 108 healthy years old, said that he had found that raw fruits and vegetables are perfectly compatible when eaten together. Melons are the exception; Walker advised making the entire meal melon if, indeed, melon is the individual's choice. However, Dr. Walker said, "If refined sugar of any kind whatsoever, or any flour product in any form or manner is eaten during the same meal with fruits (except bananas, dates, figs, or raisins) either together or within an hour or two, the sugars and starches will have a tendency to ferment in the digestive tract and sooner or later a chemical reaction (acidosis) is likely to result" (Walker 1986).

Another juice combination may be prepared from three carrots, two stalks of celery, one turnip, two beets, one-half head of cabbage, a quarter bunch of parsley, and a clove of garlic (Healing Celebrations 2002). Other juice detoxifiers are fresh lemon, grape, and green drinks (prepared from leafy green vegetables). Dilute all juice (using 1 part water to 3 parts juice) and drink throughout the day. Avoid orange or tomato juice (because of their high acid content) and never use sweetened juices (those prepared with either sugar or artificial sweeteners). Comment: There are a number of juicers that are ideal for home application but Champion Juicers, provided by Albion Enterprises (1-800-248-1475) is an excellent choice.

During the fast, select juicing materials and teas specific to health conditions (Balch et al. 1997; Horowitz 2001). For example:
  • Freshly prepared cabbage juice is excellent for ulcers, cancer, and problems affecting the colon. Do not store cabbage juice because its vitamin U content can be quickly lost. (Vitamin U, named for its ulcer advantage, is the substance in cabbage juice thought most responsible for healing ulcers in the digestive tract.)
  • Alfalfa, burdock, chamomile, dandelion, milk thistle, red clover and rose hips tea may be used to rejuvenate the liver and cleanse the bloodstream.
  • Two parts pau d'arco and echinacea tea mixed with 1 part unsweetened cranberry juice assists in rebuilding the immune system, improving bladder function, and ridding the colon of unwanted bacteria.
  • Peppermint tea has a calming, yet strengthening effect upon the nerves. It is excellent for nausea, indigestion, and flatulence.
  • Slippery elm reduces inflammation in the colon. The tea is also beneficial when used as an enema solution.
Pure vegetable broths (with no seasonings added) are excellent additions to a fast. To prepare, gently simmer vegetables in water until tender (garlic and onion may be added for their taste and healing properties). The blended or strained broths may be consumed two to three times per day. If you must eat something, select a slice of watermelon (eaten alone). Fresh applesauce (made in a blender with apple skins in tact) is highly satisfying and will not significantly disrupt the fast (Healing Celebrations 2002).

Food Transitioning On and Off a Fast

Two days prior to initiating the fast, a short cleansing diet (consisting only of raw fruits and vegetables) is strongly recommended. In addition, the faster must exercise extreme caution when breaking the fast. All benefits garnered during the fast can be forfeited by bingeing on unhealthy food choices (fast foods and those processed). Dr. Otto Buchinger commented: "Even a fool can fast, but only a wise man knows how to break a fast and to build up properly after the fast."

The main rule (regarding breaking the fast) is not to overeat. Take several days to transition into a normal diet. Initially, rely upon a small apple, a piece of melon, nectarine, or pineapple for breakfast and a small bowl of fresh vegetable soup (made from raw vegetables) for lunch. Continue with fresh juices and broths for dinner or 8 ounces of any fruit. The second day, add soaked prunes or figs, additional apples, and a fresh garden salad. The third day, include a cup of yogurt and a few finely ground nuts. Increase size of salad serving and include a boiled or baked potato. A slice of whole grain bread and a serving of cheese with soup is an appropriate evening meal. Eat slowly and chew your food well. The fourth day, return to normal eating. Try to incorporate as many healthy foods as possible (learned from the fasting experience) into your daily menus (Airola 1977; Murray 1991).

Taking Medications and Nutritional Supplements

Usually, medications are withdrawn during a fast, but exceptions occur, e.g., medications for a heart condition (a qualified physician should make the final decision regarding withholding or continuing with medications during a fast). Typically, supplements are not used, but again exceptions arise; certain health conditions may require support with appropriate supplementation. Also, even though juices provide a harvest of nutrients, some physicians use an abbreviated list of vitamins and minerals among senior fasters (Airola 1977; Balch et al.1997).

Is Fasting Safe?

Professionals, who supervise fasts, unequivocally state that a juice fast is not only the most effective healing method available but also the safest. Of course, there are certain people who should not fast and others who should only fast under the close supervision of a qualified physician. Children, still forming bone and teeth, are not candidates for fasts nor are pregnant and lactating women (the by-products of detoxification can be toxic to the infant).

According to the Fasting Center International, if the patient has advanced cancer, diabetes, tuberculosis, or cardiovascular disease, a fast should be undertaken only on the advice and direction of a competent medical doctor (FCI 2003). Also, individuals with hypoglycemia should never fast without using a protein supplement. Spirulina (a microalgae that produces twenty times as much protein as soybeans grown on an equal-sized area of land) is a popular choice (Balch et al. 1997).

Most fasters report darker urine and a catarrhal discharge from the mucous membranes during the days of solid food abstinence; others may temporarily report a coated tongue, nausea, insomnia, or feelings of anxiety.

If detoxification occurs too rapidly, allowing toxins to enter the bloodstream quicker than can be eliminated, a healing crisis (a Herxheimer Reaction) can occur. The released toxins can either exacerbate the symptoms being treated or create their own symptoms such as headaches, body ache, joint pain, dizziness, sweating, general malaise, sore throat, nausea and/or flu-like symptoms. Although the experience is not pleasant, a Herxheimer Reaction is actually a sign that healing is occurring.

The answer to a Herxheimer Reaction is to go slowly; if a healing crisis is experienced reduce the cleansing regimen, allowing the body to "catch up" in the detoxifying process. Characteristically, if unpleasant symptoms are experienced, they subside rather quickly allowing the individual to continue with normal activities. The classic response to a fast is a feeling of euphoria (high energy, clarity of thought, and an exuberant spirit).

Dr. Ragnar Berg, (an eminent Swedish biochemist), declared the famous Swedish Fast Marches a "great scientific success." All the participants in both marches (1954 and 1964) walked 325 miles over 10 days--from Gothenberg to Stockholm--with no solid food. And as participant Karl-Otto Aly, M.D., concluded:

"The marches clearly showed that humans can live for an extended period without food, and even accomplish a hard, physical effort while fasting. The general, expressed feeling among participants was that they felt stronger and had more vigor and vitality after the fast, than before it."

It was observed that serum albumin levels remained constant, as well as blood sugar levels, even though no protein was consumed over the course of the 10-day march. Researchers found that proteins in the body are in a dynamic state, being constantly decomposed, re-synthesized, and re-cycled. When old or diseased cells are decomposed, the amino acids are not wasted; instead the proteins are reused to build young, healthy cells (Airola 1977).

Steve Meyerowitz, author and fasting supporter, estimates that one day of fasting per week could provide 50 rejuvenating days per year. Meyerowitz emphasizes that the human body has an incredible capacity for healing and longevity. Within it is an innate intelligence more powerful than any drug or surgeon's knife. The body, however, needs the latitude to work and fasting grants that freedom (Meyerowitz 1999).

Seldom Are Scientific Opinions Undisputed

Opponents to fasting deride the concept, challenging that fasting has another name: starvation. According to researchers at the University of California (Berkeley), a fast will not cleanse your body of toxins; furthermore there is no evidence that the body needs an internal cleanse nor the digestive system a rest. The digestive system is quite efficient at cleansing itself and ridding the body of waste materials. The notion that stagnation and decay in the colon produce toxins that poison the body is an ancient concept that has been long ago discredited (UCB 2002).

The Berkeley account continues: "Not surprisingly, total fasting does result in a rapid initial weight loss but most of the loss is fluid, rather than fat. As the fast continues you lose body fat, but also considerable muscle (including heart muscle) and minerals. Depending upon the duration of the fast, the muscle and mineral loss can reach dangerous proportions. In any case, few people who actually lose weight via a fast maintain their loss once they renew eating habits."

According to UCB, an individual in good health can undergo a 24-hour fast without danger. Beyond a day or two, fasting can cause fatigue, headaches, irritability, nausea, low blood pressure, and heart rhythm problems. The UCB researchers emphasize that it is especially hazardous for anyone with a chronic illness such as diabetes, or liver or kidney disease to undergo a fast.

Continued . . .


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