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Intermittent fasting works – not only for weight loss but also for heart health

235 points| pseudolus | 5 years ago |washingtonpost.com

206 comments

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[+] jasonlfunk|5 years ago|reply
My experience with IF has taught me that I’m much better at complete denial, rather than moderation. So if I want to reduce my caloric intake it works better for me to say No to everything for 16 hours and only eat for 8, then to try to just eat less and in moderation all day.

It also applies to carb and other reductions. If I allow myself any bread, sweets, etc, I will eat too much. It’s easier for me to eat 0, then it is to only eat a little.

[+] Roritharr|5 years ago|reply
Same here, years of people telling me drastic diets are "unhealthy" etc. kept me from playing to my strengths of just doing the extremes for long periods of time instead of fighting constant urges while balancing them with a moderate calorie intake.

I think most (healthy) people should try fasting for 5 days to see how your body responds. It won't kill you, but many people are terrified of the thought of not eating for 12 hours.

[+] globular-toast|5 years ago|reply
Yes, that's true for me too. I've been practising 16:8 IF for almost ten years now and this is definitely one of the reasons it works. I eat big meals consisting of traditional foods. I see others people's "diets" that don't work and they are always weird foods that aren't actually nice and weird portion sizes that aren't satisfying.

The other thing I've realised is it doesn't have to be about watching the clock every day. What I actually do is just eat lunch and dinner every day and that's it. It doesn't really matter when those meals are, which means I can adjust easily to accommodate socialising, for example. The diet that works is easy to adhere to. If you have to think about it every day and shape the rest of your life around it, it will not work (unless you're a professional athlete maybe).

[+] henriquemaia|5 years ago|reply
Since I'm in sync with everyone else in this, ie, it's easier for me to shut my mouth completely than to eat in moderation, I'm guessing there's some biological drive behind this.

Maybe that happens because we, as animals, have our bodies more adapted to eat as much as we can while food is available than to risk losing that opportunity for another unknown meal in the future. That to say that it is a hardwired behavior we have, a survival strategy that makes sense in the wild.

Problem is we don't live in that environment anymore. So, I think fasting works because our bodies trigger another natural response, that of focusing our senses to the search of food, kind of accepting that food is not available. Thus, it's easier to simply not eat at all instead of trying to eat moderately.

These are my 5 cents.

[+] SideburnsOfDoom|5 years ago|reply
Agreed. The rules of the 5:2 diet that I do are easy. There's no calculation or fudge factor. Just one simple rule:

If it's a Monday or Wednesday, no I can't eat it. Else, I can.

This works so much better for me than counting calories every day, the "cheating" is eliminated.

[+] noneeeed|5 years ago|reply
Likewise. I think it's true for a lot of people.

Its why pregnant women are told not to drink alcohol at all. The reality is that the liver is amazing and can remove low levels of it so well that a small amount of drinking is fine. The problem is that it's really hard to a) effectively communicate what the safe level is b) get people to stick to it. It's much easier to avoid it entirely.

[+] hliyan|5 years ago|reply
Yet another data point. Lot easier on will power reserves to fast at a stretch. All it takes is one nibble of something and I find myself returning to the tin for more.
[+] AnIdiotOnTheNet|5 years ago|reply
My problem is, I still would have 8 hours in which I must exercise restraint. Packing away 4k calories in a single meal is trivially easy. There is no way to avoid the need for restraint and moderation.
[+] StavrosK|5 years ago|reply
Same here. I can't moderate, but just cutting things off is no problem. I've been doing 16:8 for a year where I haven't eaten a single thing outside the 8 hours, but I haven't really seen any difference.
[+] vianin|5 years ago|reply
I work exactly the same way. People think I do things in extreme, but they don't understand that it's hard to things in moderation for some people.
[+] emiliobumachar|5 years ago|reply
Interesting. Maybe a normal moderation diet is analogous to an alcoholic trying to stay sober except for drinking half a pint three times a day.
[+] AnonC|5 years ago|reply
> How do you start? Agatston told me to start by skipping one meal a day, usually breakfast. (Yes, you can have black coffee in the morning, into which he adds ghee, a type of clarified butter, and coconut oil to reduce hunger pangs. It’s not your typical cup of coffee.)

This may be ok to start with, though black coffee by itself has the ability to kill hunger without these crutches.

Adding ghee or coconut oil in black coffee means it’s no longer effectively zero calories, and this is not technically fasting. Same with adding sugar to it. You can skip breakfast and have black coffee, black or herbal teas and water — all these are effectively zero calories.

One point this article doesn’t address in the 16:8 scheme is the frequency of eating within the eight hour eating window. Is it ok to have three meals and snacks within that window? Should it be two meals with a good gap between them? I’m sure these variations also determine if it works for weight loss or other benefits.

Intermittent fasting with 16:8 makes it easier to consume lower calories. Weight loss typically follows if activity levels are maintained the same or increased (to compensate for a lower basal metabolic rate).

[+] thesz|5 years ago|reply
Please let me point you to https://leangains.com

It has a ton of info - Martin Berkhan is really first person who popularized 16:8.

One of advises there is that you can have black coffee with some milk, because milk is really low on calories.

Also, from his site again, 10g of BCAA pre and postworkout does not change expression of fasting markers in blood. 10g of BCAA is ~40 calories. Put differently, it is equal to two teaspoons of sugar.

And, to finalize, he recommends 14:10 regime for women.

[+] BiteCode_dev|5 years ago|reply
> This may be ok to start with, though black coffee by itself has the ability to kill hunger without these crutches.

I always wonderered how much ok it really was. Dreaking coffee will activate some digistive processes, and make the liver work. So you are not exactly fasting.

I never could find a study comparing with, and without coffee.

[+] SideburnsOfDoom|5 years ago|reply
> you can have black coffee in the morning, into which he adds ghee, a type of clarified butter, and coconut oil to reduce hunger pangs. It’s not your typical cup of coffee.

The idea that you need a special kind of coffee to do intermittent fasting is IMHO a very bad idea: it sets an unnecessary barrier to entry, and it misses the main point: it's about what you don't eat, not what you add to your intake.

[+] tom_mellior|5 years ago|reply
> Adding ghee or coconut oil in black coffee means it’s no longer effectively zero calories, and this is not technically fasting.

I guess it depends on how you choose to define your "technical" terms. For example (https://www.bulletproof.com/diet/bulletproof-diet/bulletproo...): "The technical definition of “fasting” describes not consuming a single calorie. When your body isn’t burdened with the task of digestion all day every day, it has a chance to carry out cleaning and repair processes that make you healthier. This cleanup and repair process is called autophagy. Depending on your diet, intermittent fasting can also put you in a fat-burning state called ketosis.[2] Learn more about the benefits of intermittent fasting.

The good news is that there’s no scientific reason to completely restrict calories to reap the benefits of intermittent fasting. If you only consume fat (no protein or carbs) during your fast, you won’t interrupt autophagy. You’ll also stay in the fat-burning state of ketosis."

(I have no opinion on any of this except that I'm amused by hobby nutritionists.)

[+] loceng|5 years ago|reply
What is often not acknowledged or even mentioned is that many people have difficulty with fasting because they are addicted to food - either addicted because of euphoric and opiate numbing effects that wheat specifically can cause, or from the numbing of sugar and carbohydrates - as inflammation has a depressant effect on the nervous system. The addiction to food is also self-medicating. If people don't realize this then they will struggle more than they need to. Reducing food intake if you're dependant on that breakfast with wheat and sugar-carbs to numb your nervous system, to calm your current emotions and perhaps pressure from past unhealed/unprocessed trauma, then as you reduce your food intake you're going to get exposed to withdrawals, as well as start being able to feel what's underlying - and you may not understand it nor know how to process it; this is certainly why intermittent fasting is perhaps healthier, gentler, and more sustainable for people to succeed at - as it won't apply or re-expose them to as much pressure with the quelling-numbing effects of many if not most foods.

Another part to why fasting can be difficult for people is as your inflammation level goes down, so does the depressant-numbing effect, so you will feel whatever digestive pains and irritation some of the foods you're eating may be causing you more clearly; this coincides with most people commenting how their thinking and senses become much sharper as they deepen into the length of a fast. If you're regularly eating foods you don't realize are agitating your GI tract, any that are causing inflammation, then the potential for fasting to be an enjoyable and easy endeavour for upkeep - weight loss or maintenance - will go down.

Edit to add: There may also be mild to severe dis-ease progression, damage/injury to the GI tract from lifelong lack of awareness (being numbed from eating foods that are harmful to you by some of the foods you may/likely have been eating) allowing the damage to progress. You may then be exposed and feeling this pain and then eating again is how you numb feeling it as strongly. Likewise there are bacterial infections that will benefit from fasting, cutting off their food supply greatly - much like why fasting can be beneficial for cancer growth - however, h.pylori bacterial infection for example causes nausea only on an empty stomach - and so that could be why some people are constantly driven to eat, not only to numb themselves but also to reduce nausea without realizing what's actually going on. That's why I also recommend microbiome stool testing. Also, if you underlying physical pain and injuries, reducing the inflammation from food will also increase your perception (and reaction to) to that physical pain - and so until you get that underlying pain treated then you'll be in a more agitated, less numbed state as well.

All of what I said above is ultimately why a practice of non-violence is necessary, non-violence towards others but also non-violence towards yourself: be gentle on yourself. I feel it's also important to state that all of this learning is a practice, an experiment you run through with yourself to understand yourself more and how things like food affect you, how breath affects you, how the mind affects you.

[+] raincom|5 years ago|reply
black coffee + ghee/coconut oil is part of keto. He must be doing keto + IF.
[+] bonoboTP|5 years ago|reply
For years I haven't been eating breakfast long before the IF craze. Mostly out of laziness. Buying all the ingredients, making sure they don't expire, preparing the food etc. is quite some time, so I gradually dropped the habit with no adverse effect. I live alone, but oh boy when people learned that I don't eat breakfast they'd get so defensive and try to tell me how unhealthy it was and how I must be underperforming because of that etc... I even got back to eating breakfast and intellectually felt good that now I'm more of a healthy normal person who does the socially acceptable normal things.

After all the IF articles I immediately went back to no breakfast with no guilt.

It's crazy how much of this stuff is in our head. The body is really really adaptive! If you get used to eating breakfast and suddenly skip it, you will feel like shit. But that doesn't mean your friend who never eats breakfast also goes through that every day. Or, if you always wake up at 9 AM, you may be shocked at those morning people who wake up at 4:30 AM. But probably if you followed their exact routine incl the evening routine, you'd find after a few weeks that it's not too bad. Surely there is a genetic component to it as well, but we underestimate the power of adaption and habits.

And most importantly, don't be so defensive when someone tells you about a strange habit of theirs while they are visibly healthy and well adjusted. Eating disorders and sudden drastic changes are of course cause for concern, but many people have a crabs in the bucket mentality and feel personally attacked when someone does something for their own health.

[+] dorkwood|5 years ago|reply
Ha, I've experienced the same thing. I'm a healthy weight and don't have any obvious health issues, but people keep telling me how bad it is that I don't eat breakfast. I've even had people tell me "yeah, you might look fine on the outside, but you're unhealthy on the inside", or imply that I'll run into health complications further down the track if I don't change my habits now.

I think food to most people is a little bit like religion: everyone wants to believe that their knowledge of nutrition is correct, and that anyone doing anything differently must be wrong.

[+] SergeAx|5 years ago|reply
Delicious breakfast gives me great mood boost for the rest of the day, so I prefer to skip dinner, or at least have it early enough to have at least 7 hours before sleep.
[+] lucb1e|5 years ago|reply
> get so defensive and try to tell me how unhealthy it was and how I must be underperforming because of that etc.

I'm pretty sure I've read somewhere that the candy industry, ahem, the breakfast cereals industry's ads and sponsored "research" is behind that.

Opening Wikipedia on Kellog's (first guess of where I might find sources on this):

> The FTC had previously found fault with Kellogg's claims that Frosted Mini-Wheats cereal improved kids' attentiveness by nearly 20%.

> In 2016 an ad telling UK consumers that Special K is “full of goodness” and “nutritious” was banned.

And from one of the sources on ftc.gov:

> At about the same time that Kellogg agreed to stop making these kinds of false claims in its cereal ads, the company began a new advertising campaign promoting the purported health benefits of Rice Krispies, according to the FTC. On product packaging, Kellogg claimed that Rice Krispies cereal “now helps support your child’s immunity,” with “25 percent Daily Value of Antioxidants and Nutrients – Vitamins A, B, C, and E.” The back of the cereal box stated that “Kellogg’s Rice Krispies has been improved to include antioxidants and nutrients that your family needs to help them stay healthy.”

> The expanded order against Kellogg prohibits the company from making claims about any health benefit of any food unless the claims are backed by scientific evidence and not misleading.

I, too, heard from my parents that "breakfast is the most important meal of the day!" and that I shouldn't skip it, and you can rationalize it with "sure, it's the first thing, a good start is half the work" or something. But that's not the same as reading the original research or at least doing a cursory search online -- something that my parents aren't used to questioning; and if they look it up, confirmation bias might play a big role.

So I don't think you can fully blame the people that got defensive about this, though I am sorry you had this experience.

To end on a more positive note, the European Union requires food to only make preapproved health claims. It feelt a bit like censorship or at least overreach when I first heard of this and I read that the number of claims made reduced very significantly (also correct claims, since it's now expensive to prove it truthful) if I remember correctly, but I guess this does stop a lot of this misinformation, at least within the EU. (https://en.wikipedia.org/wiki/Health_claim#European_Laws)

[+] tedmiston|5 years ago|reply
> After all the IF articles I immediately went back to no breakfast with no guilt.

> It's crazy how much of this stuff is in our head.

Likewise the idea that "breakfast is the most important meal of the day" being ingrained in American culture despite lacking a scientific basis [1].

[1]: https://thefastingmethod.com/tyranny-breakfast-lose-weight-v...

[+] codernyc16|5 years ago|reply
He lost 45 lbs, that’s what probably removed his sleeps apnea. Not because of some other magical ability of intermittent fasting. One of my friends also lost a lot of weight and his apnea went away, he went off of his CPAP machine.
[+] downerending|5 years ago|reply
You're probably correct, in that losing a lot of weight greatly improved his health. That said, losing weight is freaking difficult, and if intermittent fasting is a path towards that, it'd be very useful.

I've done a lot of fasting. The results seem pretty good. Pulling it off is non-trivial.

At this point, we need "magical", because nothing else has really seemed to work in general for losing weight.

(And no, didn't read the article, because paywall.)

[+] ryan-allen|5 years ago|reply
I am overweight and have OSA as a result (and treated with CPAP), I never had OSA when I was at a healthy weight.
[+] pwdisswordfish2|5 years ago|reply
Apnea can lead to binge eating, so it may be the apenea was in part responsible for gaining the 45 lbs!
[+] elric|5 years ago|reply
For anyone interested in weight loss and heart health, please remember that both are impaired by not getting enough sleep. Studies have shown that you're way more likely to over eat if you get less than 7 hours of sleep a night.

Source: "Why we sleep" by Matthew Walker.

[+] kyle_morris_|5 years ago|reply
I’ve been thinking a lot about how humans evolved and how differently we do some things. Is there consensus on the eating patterns of prehistoric humans?

My understanding of how humans evolved to eat is pretty limited, but I would guess unintentional intermittent fasting would have been commonplace in humans over the past few hundred thousand years.

There seems to be consensus that eating a large variety of foods is great for you, but is shifting your eating pattern, or even grazing, better than eating at the same time, the same amount, every day?

Does your ancestral background impact how frequently you eat? Similar to how some cultures are lactose intolerant due to historically not having access to cows, could similar issues present based on how frequently we eat?

I’d love to find resources that have dug into those topics if anyone has recommendations.

[+] tinco|5 years ago|reply
In general animals exposed to nature live shorter, not longer lives. It might be worth investigating, but I've not seen anything to suggest we might become healthier by restricting our diets to food available to effectively poor people. Besides the obvious not eating food that we already know is unhealthy and eating significantly more calories than we need.
[+] chx|5 years ago|reply
https://www.eurekalert.org/pub_releases/2018-05/esoe-cif0516... warns you intermittent fasting diets could increase diabetes risk.

I wish I had data from before but after I attempted intermittent fasting I was diagnosed with type 2 diabetes. It's possible I had it before, I alas haven't had blood work done for a few years prior. I changed my diet, never attempted fasting again and the 6.8 HbA1c dropped to and stayed steady at 5.3 almost immediately.

[+] xvilka|5 years ago|reply
There is also antifragile[1] theory of fasting - body metabolism needs randomness to prosper. So the idea is to not only do intermittent fasting, but also do it randomly, randomly change your food habits, etc. Of course, even with randomized food rations you need to keep them healthy.

[1] https://www.goodreads.com/book/show/13530973-antifragile

[+] humanlion87|5 years ago|reply
I have been following IF on-and-off over the past few years. It has helped me lose weight initially and then maintain it at a good spot. I have not done detailed before and after blood work to know whether it has had other effects. But one problem I have started having recently is acid reflux and acidity. People immediately pounce on this and tell me that skipping breakfast is what is causing increased acidity levels in my stomach. And my doctor is also suggesting that I do not skip breakfast. The problem is I do not have any concrete evidence for either case (skipping breakfast causes/does not cause acidity). I am hoping to get my acidity issues under control first and then maybe give IF another shot to see whether the acidity issues return. Just wanted to throw out there that different people might have different experiences with IF and it is very important to listen to your body.
[+] bmd3991|5 years ago|reply
Binge eating can cause acid reflux, so I wonder if it’s a similar mechanism. Something about eating so much food in a small window maybe (?) doesn’t give your body time and space to digest it properly
[+] konradb|5 years ago|reply
I had acid reflux for a number of years. It got more and more acute until it felt almost like how I imagine a heart attack to feel. In the end after a week in hospital I had my gallbladder removed and subsequent to that any very occasional mild acidity has gone away after a drink of water. Another anecdote that might be worth adding to the collection.
[+] SideburnsOfDoom|5 years ago|reply
> Although it sounds counterintuitive, long periods without eating actually decrease your levels of the “eat now” hormone ghrelin.

I could not tell you if this is psychology or hormonal, but it seems to me after having done it, that the benefit of intermittent fasting is not just "fewer calories on average due to fast days" but also shifting the point at which the body starts to sound the alarms about hunger. You "get used" to not being sated, and it feels less like a problem that needs fixing, at least for a few hours longer. This happens at some level well below conscious thought.

[+] HiddenCanary|5 years ago|reply
At university I used to intermittent fast as a side-effect of laziness to cook breakfast.

Nowadays I've read the benefits of it and trying to replicate that but I just get severe headaches when trying to do it. Anyone got any tips for avoid thing that?

[+] wahern|5 years ago|reply
Two of the most common culprits to rule out would be 1) caffeine withdrawal and 2) dehydration. People often don't drink as much, or not at all, when they're not eating, and many don't even realize it.

When I work an all-nighter (36+ hours without sleep) I don't have much of an appetite the next day and so tend not to eat anything. Because I'm not eating I'm also not drinking much, which I like because I'm prone to slide into a salt+soda spiral. But if I don't force myself to drink fluids I often end up with a raging headache.

I'm not much of a breakfast eater and during periods when I drink a lot of caffeinated soda I often get headaches from the caffeine withdrawal, especially on the weekends as I tend to only drink soda when working.

[+] loceng|5 years ago|reply
An accelerated version of intermittent fasting is longer term fasting - ideal minimum being 3 days, although even only being able to handle 24 hours at first is a great start; the next ideal number of days is 5 days, then 10 days, then 20 days based on different changes that occur at those periods.

I always recommend people watch this by Dr. Jason Fung: 'Therapeutic Fasting - Solving the Two-Compartment Problem' - https://www.youtube.com/watch?v=tIuj-oMN-Fk

[+] badrabbit|5 years ago|reply
If you can break your carb addiction the rest is not that hard. It was very similat to quitting cigarettes for me. Cut off carbs for a few days, it will feel horrible until day 3, then you almost feel euphoric but you still have an urge. Keep it up for a week then you start replacing the old habit with a new one (intermittent fasting with keto diet for example, or cardio). Even when I slack off, so long as I don't touch carbs I can just cut down on food intake or workout a little bit and I will have so much more energy. If I actually workout properly, people will notice changes in my energy level and attitude. It's really insane why it is so hard to make simple changes with immense benefits like this. I feel normal after stopping cigs and other vices but I am telling you, cutting out or extremely reducing carb intake has had the most impact on my life. If I didn't know better I'd be calling carbs an addictive harmful drug (in reality, our modern way of life that requires minimal carbs for fuel and healthy bodies that are energy efficient are causing a conflict with traditional meals and ingredients). Once you get some control/discipline over what you eat, controlling when you eat is a lot easier in my experience. When it gets hard to stick to the diet, intermittent fasting can compensate for lack of good calories.
[+] bonestormii_|5 years ago|reply
I am strongly prone to skipping breakfast and drinking black coffee all day long, but I honestly do feel like it leaves me with less energy at the end of the day, and makes me less likely to exercise.

If you are overweight, any weight loss may be good. If you aren't really overweight, eating healthy regularly timed meals and working out are probably a better bet for maintaining your physique.

[+] arkj|5 years ago|reply
>Intermittent fasting took off in the United States in part due to a 2014 TEDx Talk (“Why fasting bolsters brain power”) by Mark Mattson

The link points to Michael Mosley's 2012 BBC documentary. Mark Mattson's TEDx talk from 2014 is here https://www.youtube.com/watch?v=4UkZAwKoCP8

[+] slothtrop|5 years ago|reply
Early intermittent fasting is the most powerful variation, on two fronts. First, early dinner improve weight loss rate while conversely very late dinner worsen it, along with glucose tolerance. Second, consuming high protein breakfast has strong associations with weight loss and better lipid profile. You can get the best of both worlds.

There's lots of research to this effect - https://www.nature.com/articles/ijo2012229, https://journals.plos.org/plosbiology/article?id=10.1371/jou..., https://academic.oup.com/jn/article/127/1/75/4728738 , https://onlinelibrary.wiley.com/doi/full/10.1002/oby.20460, https://academic.oup.com/ajcn/article/104/4/1160/4557123, https://academic.oup.com/ajcn/article/104/4/982/4557122, https://www.mdpi.com/2072-6643/11/11/2624/htm?sfns=mo, https://www.nature.com/articles/ejcn2016182, https://www.sciencedirect.com/science/article/pii/S027153171...

[+] 2T1Qka0rEiPr|5 years ago|reply
I lost a little over 50lbs a number of years ago, following a 5:2 diet. Quite frankly, I found it pretty horrible. Selecting 2 days in which you won't eat (much) is pretty tough, and the obvious candidates would be your working days, but you should expect to be grumpy AF during them in all honesty.

These days, I generally stick to a 16:8 approach of IF (I typically eat between 13:00-21:00). I find that it works pretty well for me. I should note that I'm very active (exercise every day, running, cycling, or lifting weights), and that I still typically eat 3 meals, albeit within a smaller window. I think being sceptical of food science is smart, so all I can say is that it works for me.

[+] BrandoElFollito|5 years ago|reply
One day I decided to skip breakfast (I am not really hungry in the morning). I would eat at 20:00 and then at 12:00 the next day. 16 hours of fasting for a year or so (I still continue, recently gave up because of COVID but will be back when normality is back too).

I was not hungry, I did not loose weight, I did not feel better or worse.

I wonder whether some people are just optimized for this eating style, without specific impacts on their health or body.

[+] Izkata|5 years ago|reply
> How do you start? Agatston told me to start by skipping one meal a day, usually breakfast.

This sounds especially odd to me, as skipping breakfast has long been one of those well-known ways to accidentally gain weight... (explanation typically being that you end up hungrier at lunch/dinner and eat more over the whole day)

[+] Broken_Hippo|5 years ago|reply
Are we sure about this? I mean, wasn't "breakfast is the most important meal of the day" an advertising slogan to sell more?

Additionally: I think this probably has more to do with the person. My mother is outright miserable without breakfast, which makes sense. She is hungriest early in the day. She doesn't have much issue completely skipping dinner or eating very little the rest of the day. I'm the opposite. Eating too early means I simply eat more food that day - and I'm not even hungry the first hour or two that I'm awake. I don't see a point in eating when I'm not hungry, so I generally don't. It is much easier to simply skip food early in the day, snack on something small for lunch (cheese and bread, fruit, etc), and have a nice dinner.