Cardiologist Andrew Freeman Md On How To Make It Work For The Heart
The best approach to intermittent fasting for patients’ heart health may be a combination strategy, according to Andrew M. Freeman, MD, director of cardiovascular prevention and wellness at National Jewish Health in Denver.
Freeman, who serves as co-chair of the American College of Cardiology’s nutrition and lifestyle workgroup, answered MedPage Today‘s questions about the popular diet. A lightly edited transcript follows.
What should healthcare professionals know about intermittent fasting?
First, I usually tell everybody that there are always going to be fad diets and changes to the status quo that sometimes really are quite beneficial and sometimes not. Fasting has been around for eons. Human beings did not always have food abundance like we have today. And so fasting is probably a natural thing, which is why we store fats.
In short, fasting is a great way to become more mindful about your food choices and when you eat and what you’re eating. When you’re only eating, say, 4 hours out of the day or 6 hours out of the day or even 8 hours out of the day, you really limit yourself. The goal then is to become mindful about what you’re doing and how much you’re doing rather than the so-called mindless eating which we find everywhere.
What are the cautions when thinking about intermittent fasting?
How does this interact with the data around eating versus skipping breakfast?
What is the worst thing you can do for your heart from a diet standpoint?
Disclosures
Does Intermittent Fasting Have Different Effects On Men And Women
The quick answer is: yes, Intermittent Fasting can affect men and women differently.
Anecdotally, we have many women in our online coaching program that swear by Intermittent Fasting, while others have had adverse effects.
Lets dig into the science and studies.
A recent PubMed summary concluded thatfasting can be prescribed as a safe medical intervention as well as a lifestyle regimen which can improve womenâs health in many folds .
Now, in that extract, many of the studies cited are focused on specifically calorie restriction , and they also say that future studies should address this gap by designing medically supervised fasting techniques to extract better evidence.
Digging into the PubMed Archives brought me to the following conclusions :
One small study resulted in the following: Glucose response to a meal was slightly impaired in women after 3 weeks of treatment, but insulin response was unchanged. Men had no change in glucose response and a significant reduction in insulin response.
Another small study studied the effects on their menstrual cycles after a 72 hour fast which is significantly longer than any fast recommended in this article: in spite of profound metabolic changes, a 72-hour fast during the follicular phase does not affect the menstrual cycle of normal cycling women..
Precision Nutrition a great resource recommends not attempting Intermittent Fasting as a woman if:
- Make sure you are getting enough sleep.
You know your body best.
Lose Weight With Less Effort
It’s important to consult your doctors with any medical concerns, and before making any changes or adding supplements to your health plan.
Dieting can be daunting. The idea of cutting out your favorite foods isn’t likely to put a smile on your face. That’s why there is one particular weight loss method that is catching more and more attention nowadays: intermittent fasting. Unlike most diets out there, intermittent fasting does not require you to eliminate any foods from your life. It doesn’t dictate what you eat, rather when to eat.
In this respect, intermittent fasting is not so much a diet in the conventional sense, but more aptly described as an eating pattern. Fasting is not unnatural, either. Hunters and gatherers didn’t have the luxury of grocery stores or refrigerators, for example, so they would often go long periods without eating any food. As a result, humans evolved to be able to withstand and function without food for extended periods of time. That is why your body is more than capable of coping with intermittent fasting.
Recommended Reading: What Foods To Eat While Intermittent Fasting
Should I Eat 6 Small Meals A Day
There are a few main reasons why diet books recommend six small meals:
1) When you eat a meal, your body does have to burn extra calories just to process that meal. So, the theory is that if you eat all day long with small meals, your body is constantly burning extra calories and your metabolism is firing at optimal capacity, right? Well, thats not true.
Whether you eat 2000 calories spread out throughout the day, or 2000 calories in a small window, your body will burn the same number of calories processing the food .
So, the whole keep your metabolism firing at optimum capacity by always eating sounds good in principle, but reality tells a different story.
2) When you eat smaller meals, you might be less likely to overeat during your regular meals. I can definitely see some truth here, especially for people who struggle with portion control or dont know how much food they should be eating.
However, once you educate yourself and take control of your eating, some might find that eating six times a day is very prohibitive and requires a lot of effort. I know I do.
Also, because youre eating six small meals, Id argue that you probably never feel full, and you might be MORE likely to eat extra calories during each snack.
Although grounded in seemingly logical principles, the six meals a day doesnt work for the reason you think it would , and generally only works for people who struggle with portion control .
Thats why we made this:
Fasting: New Twist On An Old Tradition
Historically, the word breakfast described the first meal of the day no matter when that meal occurred. It wasnt until the 15th century that the word started being recognized as the meal you consume shortly after waking.
Nowadays, with intermittent fasting gaining popularity, the meaning of the word breakfast is going back to its original roots. Breakfast for the intermittent faster is the meal consumed when you choose to break your fast, be it 6:00 AM or 6:00 PM.
Fasting, especially for religious purposes, has been a common occurrence for centuries. And generally, throughout most of human history, not much concern was given to how to break the fast.
However, in an age of poor dietary advice, when we are told to eat all day long and when hyper-palatable highly processed food abounds it can take a little more planning to resume eating in a way that achieves the most physical comfort and most effective results for your long-term health and weight loss goals.
Recommended Reading: How Much To Eat When Intermittent Fasting
There Is Interest In Whether Autophagy Can Increase The Lifespan Of Whole Organisms Though So Far This Has Only Been Replicated In Animals
There is interest in whether autophagy can increase the lifespan of whole organisms, too though so far this has only been replicated in animals, like 1mm-long nematode worms and mice, and not humans . Until there are longitudinal studies of human intermittent fasters, it is too soon to say that it will extend our lifespans.
But, other animal studies have linked autophagy to improvements in immune system memory. The fact that autophagy is essential to maintain cell health has also generated interest in its role in cancer suppression. There might be more reasons than increasing lifespan to take interest in autophagy.
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For most of us, autophagy occurs in our sleep, but it is also brought on by exercise and starvation. Could controlled fasting help to trigger it?
Unlike calorie-restrictive diets , the purpose of intermittent fasting is to increase the amount of time between the last meal of one day and the first of the next. This could help to promote autophagy, but to understand how we should look at what happens to us after we eat.
Eating even a small bite before bed extends the “fed state”, meaning you may never achieve ketosis before your next meal
When you stop eating at 19:00 you will still be in the fed state until 22:00 because you will still be digesting nutrients, says Clarkson. Any carbohydrates in your diet will give you a nice supply of glucose, our premium source of fuel, for a few hours.
How To Get Started
Getting started is simple.
In fact, chances are youve already done many intermittent fasts before. Many people instinctively eat this way, skipping morning or evening meals.
The easiest way to get started is to choose one of the intermittent fasting methods above and give it a go.
However, you dont need to necessarily follow a structured plan.
An alternative is to fast whenever it suits you. Skipping meals from time to time when you dont feel hungry or dont have time to cook can work for some people.
At the end of the day, it doesnt matter which type of fast you choose. The most important thing is to find a method that works best for you and your lifestyle.
Summary
The easy way to get started is to choose one of the methods above and give it a go. Stop immediately if you experience any adverse effects.
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Can You Have A Cheat Day While On Intermittent Fasting
As with any diet or eating routine, cheat meals are fine, as long as they dont become a cheat day. Its a marathon, not a sprint. Focus on staying on track long-term, and if that requires an occasional cheat meal its okay! Enjoy your dish, savor the flavors, and come back to your old routine as soon as possible.
Read Also: Intermittent Fasting For Type 2
Eat Breakfast As Late As You Can
Brisco points out that its easier to fast overnight and then push back your breakfast time. If you usually eat breakfast at eight, try to push it to nine or 10, she says. Then, you can gradually push it to whenever you want, like 12 or 1 oclock. Brisco says its helpful for her to be busy in the morning so that shes not thinking about food. Once I get to the office, I forget about food, she says. Eventually Im like, Oh! I need to eat! I was surprised at how long I could push back my first meal.
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Benefits Of Intermittent Fasting
Can intermittent fasting improve your health? Recent research has found that using intermittent fasting for weight loss may have some benefits in the short term.
It appears that fasting for a short time can produce ketosis, which is a process that occurs when the body doesn’t have enough glucose for energy, so it breaks down stored fat instead. This causes an increase in substances called ketones. This, coupled with fewer calories consumed overall, can lead to weight loss. Research suggests that alternate-day fasting is about as effective as a typical low-calorie diet for weight loss.
Fasting also affects metabolic processes in the body that may work to decrease inflammation, as well as improve blood sugar regulation and physical stress response. Some research shows this may improve conditions associated with inflammation like arthritis, asthma and multiple sclerosis.
Little long-term research has been done on intermittent fasting to examine how it affects people over time. As a result, long-term health benefits or risks are unknown.
The : 2 Fasting Method Is Suitable For Those Looking For An Easier Approach To Fasting
“The 5:2 fasting method requires a person to fast for two non-consecutive days per week,” Yule told INSIDER. On fasting days, she said a person consumes no more than 500 to 600 calories. A person might choose this type of fast because it is easier in the sense that they only have to be restrictive once or twice a week, she added.
Yule explained, however, that a major con to the 5:2 fasting method is that it might be very difficult to maintain over the long-term. “The person may feel fatigued, hungry, or irritable on the days that they are consuming so little food, and that could make the workday unpleasant,” she said.
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Is Arbonne A Scheme
Arbonne is an MLM company that operates in the United States, Canada, the United Kingdom, and a number of other countries. While MLM schemes arent illegal, theyre often predatory. Arbonne is no exception, as there are concerns that the company uses misleading promises and sales tactics.
In fact, its been found that 96% of Arbonne consultants even those who are higher ranked as regional vice presidents do not make a livable wage. Most Arbonne consultants make less than $200 per year. These statistics call the companys business practices into question .
Prolonged Fasting For 3
This involves going with no calories for 3-5 days. These types of fasts are usually done under medical supervision. All studies of prolonged fasting allow up to 500 calories during fasting days. These calories should come from low-protein, low-carb foods. This usually means vegetable juices and vegetable soup, averaging a total calorie intake of 200250 kcal and 2535 g of carbohydrates per day. Our CEO does quarterly 5-day modified fasts in which he eats 2 cups of mixed greens with olive oil and a handful of almonds for a total of 250 calories.
Do not attempt a multi-day fast with water only. All clinical trials of multi-day fasts involve at least minimal calorie and micronutrient intake.
Also Check: What Is The Most Effective Fasting Method
Optional Step : Prepare For Life After The 30 Days
After completing the 30 days, Arbonne recommends that you continue using all Arbonne products, meaning the protein shake, fizz sticks, digestive support, and so forth.
Further, you should work closely with your independent consultant, the person you buy your products and program from, to identify foods you should reintroduce or exclude from your diet.
Interestingly, Arbonne suggests that you will need to do the 30 Days to Healthy Living program more than once, which calls into question whether the program actually works and whether its intended to make people become reliant on the companys products.
Supports Cellular Renewal And Repair
Research has shown that fasting supports the process of autophagy. During autophagy, your body breaks down and destroys old, damaged, and abnormal cells and recycles them for energy. This cellular spring cleaning leaves room for your body to create new and healthy cells. It also supports cellular repair and regeneration, reduces the development of abnormal cell growth, and keeps your cells and tissues healthy.
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If I Didnt Eat For 24 Hours Id Die
Medical practitioners have noted the health benefits of fasting for thousands of years. In other words, fasting isnt some new fad or a crazy marketing ploy. Its been around for a long time and it actually works. Youve probably already fasted many times, even though you dont know it. Have you ever slept in late on the weekends and then had a late brunch? Some people do this every weekend. In situations like these, we often eat dinner the night before and then dont eat until 11 am or noon or even later. Theres your 16hour fast and you didnt even think about it.
Calibrating Your Fasting Protocol
The smart way to calibrate your fasting protocol is by easing into it. Start with a 12 hour fast and scale up from there until you find a program that works best for your body.
Heres how that might look schedule-wise on a week-by-week basis.:
- 1 week of 12-hour fasting
- 3 days of 13-hour fasting
- 3 days of 14-hour fasting
- 3 days of 16-hour fasting
- 3 days of 18-hour fasting
- Once you have established which IF protocol works best for you, you can then maintain this level, listen to your body, and adjust if needed.
If you experience discomfort at any level, drop back down to a more sustainable routine.
Remember that the goal isnt to fast as long as possible or shed pounds as quickly as you can. The aim is to find a sustainable intermittent fasting schedule that suits your lifestyle and individual health needs. To keep things simple, you can use a diet tracker app like Carb Manager to help implement and maintain your custom intermittent fasting program . This way, you can record all your essential health metrics in one place. Once you have established your routine, you can sit back and reap the rewards of your progress.
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Should You Do Intermittent Fasting And The Keto Diet
We have a crazy extensive guide on the Keto Diet in case youre not familiar with it, so here it is in a nutshell:
This process is called ketosis, and there are two ways for a body to enter ketosis:
- Eating in a way that induces ketosis .
- FastingHey, thats what youre reading about right now!
We actually have an amazing success story here on Nerd Fitness, Larry, who followed our strategies, went Keto and start intermittent fasting. He ended up losing weight, getting stronger, AND overcame the challenges of rheumatoid arthritis !
Heres how the fasting portion of it works:
As your body enters a fast period when there are no sources of glucose energy readily available, the liver begins the process of breaking down fat into ketones.
Fasting itself can trigger ketosis.
Fasting for a period of time before kicking off a Keto-friendly eating plan COULD speed your transition into the metabolic state of ketosis, and fasting intermittently while in ketosis could help you maintain that state.
I personally love fasting for the simplicity: I skip breakfast every day and train in a fasted state. Itâs one less decision I have to make, itâs one less opportunity to make a bad food choice, and it helps me reach my goals.
WHY KETO + IF WORKS = eating Keto can be really challenging. And every time you eat, itâs an opportunity to do it wrong and accidentally eat foods that knock you out of ketosis.
Youâre also tempted to overeat.
Your value may vary!
