Son sees success with fasting strategy

Dear Dr. Roach: My adult son has lost over 100 pounds on an intermittent fasting diet (16 hours fasting per day) and now wants to continue fasting in the morning and just eat a heavier lunch and dinner to maintain his new weight. I am not sure that this kind of long-term fasting is good for his health.

I have told him that it is better for his health if he eats more of a Mediterranean-style diet.

Could you advise us what you think is a good way to maintain weight loss after being on an intermittent fasting diet?

G.B.

Answer: My experience is that intermittent fasting is an effective strategy for some people in whom other strategies have been unhelpful.

Your son has had success with his fasting strategy. I have seen over and over again people having success with their plan, only to go back to their old dietary habits and have the weight come back on. I would recommend he continue with the intermittent fasting.

Dear Dr. Roach: In a recent column, a reader was concerned about his enlarged prostate and possible UTI. You wrote that he may possibly benefit from changing the pH of his urine, but you did not specify which way. It implied that acidic urine could be a problem. However, doesn’t the drug Hiprex given for recurring UTIs help prevent infections by making the urine acidic?

J.B.

Answer: Methenamine (Hiprex) is converted in an acidic environment (a pH below 5.5) to ammonia and formaldehyde. Formaldehyde is not an antibiotic, but does have general bacteriakilling effects. Hiprex also contains two organic acids, hippuric acid and mandelic acid, which help keep the urine pH low so the drug will work. Other physicians prescribe vitamin C in addition to help ensure an acidic urine. So, it’s not the acidic urine that kills the bacteria with methenamine, it’s that the drug is converted to bacteria-killing formaldehyde in the acidic urine. Most bacteria are relatively resistant to the acidic pH changes that are possible in the urine.