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Intermittent Fasting

What is intermittent fasting?

  • Intermittent fasting is way of timing your meals to allow you to be in a non-fed state for relatively long periods of time. 

What is a “non-fed” state?

  • A non-fed state also known as the “post-absorptive state” is a physiologic state where your body has consumed easily accessible energy sources like sugar and glycogen. When you have depleted those stores, your body will start using fat as an energy source. You will need to abstain from eating for at least 8-12 before you actually reach the “non-fed” state
  • What is the advantage of being in the “non-fed” state? 
  • While in the “non-fed” state, you will burn your own fat for energy; this will help you to reduce your body fat. More importantly, fasting (being in the non-fed state for extended periods of time) will reduce your insulin levels. Chronically elevated insulin levels (resulting from lack of being in the non-fed state) leads to insulin resistance (IR).

Why is Insulin Resistance (IR) so detrimental to health?

  • Research is demonstrating that insulin resistance (IR) is the root cause of many chronic diseases including heart disease, high blood pressure and type II diabetes. IR also contributes to weight gain, hypothyroidism, cancer, mortality from covid-19 and other chronic inflammatory diseases.

Doesn’t a calorie-restricted diet do the same thing?

 

  • No! Calorie restricted diet eventually will fail because your metabolism slows down under conditions calorie restriction. Intermittent fasting dose not restrict caloric intake, instead IF restricts the timing of your meals. IF does not slow your metabolism. Improving your insulin sensitivity will actually increase your metabolism.

Transitioning to Intermittent Fasting

  • Step 1 – stop snacking – eat three meals each day – do not eat between meals 
  • Step 2 – stop consuming sugar, reduce excess carbohydrate intake 
  • Step 3- Do not eat your first food of the day (breakfast) until you are hungry 
  • Step 4 – Eat your breakfast later and later in the morning as you start to become more fat adapted
  • Step 5 – Eat two meals each day
  • Step 6 – eat your first meal later and your last meal earlier to increase the amount of time that you are in the non-fed state

Tips for success

  • Reduce your carbohydrate intake levels – carbohydrates stimulate insulin 
  • Avoid excess amounts of protein – protein can be turned into carbohydrates, which then increase insulin
  • Eat healthy fats – Meat, eggs, cheese, coconuts, chicken, pork ….Avoid polyunsaturated fats (PUFA) – PUFA are found in nuts and seeds, nut butters margarine, commercial mayonnaise and salad dressings (usually in the form of canola oil or soy oil) and many processed foods
  • Eat real food- avoid protein powders, power bars, avoid processed foods. Protein powders often contain BCAA (branched chain amino acids) that can spike your insulin levels
  • Drink plenty of water – avoid juice, diet drinks
  • Avoid artificial sweeteners- they can spike you insulin levels 
  • Get enough restorative sleep – poor sleep is very stressful, raising your cortisol levels, leading to high blood sugar, elevated insulin and finally insulin resistance 
  • Reduce your stress – any aspect of your life that contributes to excess stress can raise your cortisol levels, leading to high blood sugar, elevated insulin and finally insulin resistance
  • Do short bursts of high intensity training (HIT). HIT will help to increase your metabolic rate 
  • Do not try to starve yourself – this is not sustainable and will slow your metabolism
  • Do not overeat when breaking your fast – eat slowly in a calm, relaxed atmosphere. 
  • Be flexible with your eating schedule 
  • Plan ahead with what you are going to eat to break your fast-Do not just “grab something” because you are tired or hungry or time pressured

What Should I Eat?

  • Put a “Log on the Fire” every meal
  • The “Log on the Fire” = Good Fats
  • What kind of fat should I consume?

Saturated Fats, Won’t They Hurt Me?

  • This is not true
  • The notion that saturated fat is bad was created by the food industry to sell margarine, vegetable and seed oils

Numerous Studies “Proving” That Cholesterol is the Root Cause of Heart Disease were done on Rabbits

Health is Achieved Toward the Middle of the Curve

Paracelsus

  • This is not true
  • The notion that saturated fat is bad was created by the food industry to sell margarine, vegetable and seed oils

Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease

  • Patty W Siri-Tarino, Qi Sun, Frank B Hu and Ronald M Krauss 1 From the Children’s Hospital Oakland Research Institute Oakland CA   Harvard School of Public Health Boston MA. 
  • ABSTRACT 
  • Background: A reduction in dietary saturated fat has generally been thought to improve cardiovascular health. 
  • Objective: The objective of this meta-analysis was to summarize the evidence related to the association of dietary saturated fat with risk of coronary heart disease (CHD), stroke, and cardiovascular disease (CVD; CHD inclusive of stroke) in prospective epidemiologic studies. 
  • Design: Twenty-one studies identified by searching MEDLINE and EMBASE databases and secondary referencing qualified for inclusion in this study. A random-effects model was used to derive composite relative risk estimates for CHD, stroke, and CVD. 
  • Results: During 5–23 y of follow-up of 347,747 subjects, 11,006 developed CHD or stroke. Intake of saturated fat was not associated with an increased risk of CHD, stroke, or CVD. The pooled relative risk estimates that compared extreme quantiles of saturated fat intake were 1.07 (95% CI: 0.96, 1.19; P = 0.22) for CHD, 0.81 (95% CI: 0.62, 1.05; P = 0.11) for stroke, and 1.00 (95% CI: 0.89, 1.11; P = 0.95) for CVD. Consideration of age, sex, and study quality did not change the results. 
  • Conclusions: A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD. More data are needed to elucidate whether CVD risks are likely to be influenced by the specific nutrients used to replace saturated fat. 
  •  

Harvard Medical School Published in the American Journal of Clinical Nutrition January 2010

  • Conclusions: A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD
  •  

Breast Milk

  • 55% of the calories from breast milk come from Saturated Fats
  • Also high in Cholesterol
  •  

Low Intake of Saturated Fat

  • Lowers Levels of HDL “good cholesterol”
  •  

Effect of low-fat diets on plasma high-density lipoprotein concentrations.

  • Katan MB.
  • Department of Human Nutrition, Wageningen Agricultural University, The Netherlands.
  • Low concentrations of HDLs in plasma are a strong predictor of risk for coronary as well as other cardiovascular diseases. There is increasing evidence that this relation is causal and that interventions that change HDL concentrations also change risk. One such intervention is exchanging fat and carbohydrate. In controlled trials, low-fat, high-carbohydrate diets decrease HDL concentrations. The effect is strongest when carbohydrates replace saturated fatty acids, but is also seen when carbohydrates replace mono- and polyunsaturated fatty acids carbohydrates. The effect is seen in both short- and long-term trials and therefore appears to be permanent. This finding is supported by epidemiologic studies in which populations eating low-fat, high-carbohydrate diets were shown to have low HDL concentrations. Weight losses with consumption of low-fat diets could theoretically counter effects on HDL, but in published trials weight losses have been modest and insufficient to offset the decrease in HDL concentrations induced by carbohydrates. Thus, replacement of saturated fat by carbohydrates adversely affects plasma HDL concentrations; replacement of saturated fat by unsaturated fatty acids deserves consideration as an alternative.
  • PMID: 9497172 [PubMed – indexed for MEDLINE]

American Journal of Clinical Nutrition

  • In controlled trials, low-fat, high-carbohydrate diets decrease HDL concentrations. The effect is strongest when carbohydrates replace saturated fatty acids

Metabolic Syndrome

  • A syndrome of high blood pressure, diabetes, obesity and heart disease initially recognized by Dr Reavens  
  • One of the most important causes of disease in the world

Hippocrates 2,500 Years Ago

  • “All Disease begins in the Gut”
  • Every time you eat or drink, you are either  enhancing your health or promoting disease

The Food Pyramid, Which is Based on a High Carb-Low Fat Diet Contributes to High Blood Pressure, Diabetes, Obesity and Heart Disease

Hidden or “stealth organisms” – viruses, bacteria, parasites can contribute to chronic stress and adrenal stress

Problem – Eating too Frequently

  • Myth – eating small, frequent meals will “boost your metabolism” 
  • Fact – every time you eat, your pancreas secretes insulin and excess insulin is a root cause of weight gain
  • Solution – Eat no more than 3 times each day, no snacking

Problem – Eating a Low Fat Diet

  • Myth – eating fat makes you fat
  • Fact- Excessive carbohydrates (and even excessive protein) can raise your insulin levels leading to weight gain
  • Solution – eat a substantial portion of healthy fats with each meal

High Carbohydrate Diets, Triglyceride Rich Lipoproteins, and Coronary Heart Disease Risk American Journal of Cardiology 2000

  • Abbasi F, McLaughlin T, Lamendola C, Kim HS, Tanaka A, Wang T, Nakajima K, Reaven GM.
  • Stanford University School of Medicine, California, USA.
  • In this study we compared the effects of variations in dietary fat and carbohydrate (CHO) content on concentrations of triglyceride-rich lipoproteins in 8, healthy, nondiabetic volunteers. The diets contained, as a percentage of total calories, either 60% CHO, 25% fat, and 15% protein, or 40% CHO, 45% fat, and 15% protein. They were consumed in random order for 2 weeks, with a 2-week washout period in between. Measurements were obtained at the end of each dietary period of plasma triglyceride, cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, remnant lipoprotein (RLP) cholesterol, and RLP triglyceride concentrations, both after an overnight fast and throughout an 8-hour period (8 A.M. to 4 P.M.) in response to breakfast and lunch. The 60% CHO diet resulted in higher (mean +/- SEM) fasting plasma triglycerides (206 +/- 50 vs 113 +/- 19 mg/dl, p = 0.03), RLP cholesterol (15 +/- 6 vs 6 +/- 1 mg/dl, p = 0.005), RLP triglyceride (56 +/- 25 vs 16 +/- 3 mg/dl, p = 0.003), and lower HDL cholesterol (39 +/- 3 vs 44 +/- 3 mg/dl, p = 0.003) concentrations, without any change in LDL cholesterol concentration. Furthermore, the changes in plasma triglyceride, RLP cholesterol, and RLP triglyceride persisted throughout the day in response to breakfast and lunch. These results indicate that the effects of lowfat diets on lipoprotein metabolism are not limited to higher fasting plasma triglyceride and lower HDL cholesterol concentrations, but also include a persistent elevation in RLPs. Given the atherogenic potential of these changes in lipoprotein metabolism, it seems appropriate to question the wisdom of recommending that all Americans should replace dietary saturated fat with CHO.

American Journal of Cardiology 2000

  • The 60% CHO diet resulted in higher (mean +/- SEM) fasting plasma triglycerides (206 +/- 50 vs 113 +/- 19 mg/dl, p = 0.03), RLP cholesterol (15 +/- 6 vs 6 +/- 1 mg/dl, p = 0.005), RLP triglyceride (56 +/- 25 vs 16 +/- 3 mg/dl, p = 0.003), and lower HDL cholesterol (39 +/- 3 vs 44 +/- 3 mg/dl, p = 0.003) concentrations, without any change in LDL cholesterol concentration
  • 2 weeks on the lower carbohydrate/higher saturated fat diet cut triglycerides almost in half, while at the same time increasing HDL

Manifestations of Low Saturated Fat Diet

  • Lowers HDL (“good” cholesterol)
  • Lowers sex hormone levels
  • Contributes to metabolic syndrome (weight gain, high blood pressure, diabetes, heart disease)

Benefits of Proper Intermittent Fasting

  • Sustainable Weight Loss
  • Improvement in lipid parameters, lowers triglycerides, raises HDL
  • Lowers insulin levels, reduces insulin resistance
  • Helps overall health with less inflammation and less chronic degenerative illness
To learn more about Michael Rothman MD contact us today by giving us a call at (732) 268-7663, emailing us at [email protected] or by requesting an appointment online.

While mainstream health professionals such as doctors, nutritionists, and dietitians recommend eating several small meals throughout the day, scientific studies reveal that limiting yourself to eating two or three large meals is the key to healthy living and maintaining a healthy weight.  As there is no science to prove that eating multiple small meals or snacks throughout the day “boosts your metabolism” it’s truly a mystery as to why the medical community continues to recommend these unfounded, unhealthy diets.  In fact, by the end of this blog, I hope you consider eating less frequently and continue to educate yourself about the metabolic benefits of intermittent fasting.

Why would I want to eat fewer meals?

Each time you eat, your blood sugar increases.   As you’re digesting your meal, your pancreas releases insulin into your bloodstream to lower your blood sugar. This insulin release causes your blood sugar to be reduced, however if your sugar drops too low (a condition known as reactive hypoglycemia) you will quickly be hungry again. Consequently, because you’re hungry, you eat again, which then stimulates another insulin release, and again you are hungry. This cyclical pattern of consuming frequent small meals can eventually cause your insulin levels to rise to dangerously high levels and is very detrimental to your health. Excessive levels of insulin in your bloodstream contribute to inflammation throughout your body, which can cause a myriad of health issues including diabetes, heart disease, high blood pressure, cancer and other chronic problems.

What is Intermittent Fasting and why would I want to do it?

Firstly, intermittent fasting is not a diet, but more so a scheduled program of eating.  It’s a way to plan your meals to keep your blood sugar stable while minimizing insulin release and insulin levels.  I’d like to emphasize that while this pattern of eating focuses on when you eat, it will not work unless you correctly choose what you eat.  Therefore, if you do not eliminate fast food meals, fried foods, low fat foods, excessive carbohydrates and high sugary snacks from your diet, this method will not be effective.  Generally, intermittent fasting can be a simple eating lifestyle which has a large positive impact on your metabolism and in turn help you improve your health and lose weight. 

How does Intermittent Fasting Work?

Essentially, your body is in a “fed state” immediately after you eat a meal and you are digesting and absorbing the nutrients.  As a general rule of thumb, this “fed state” begins when you start eating and ends about three to five hours later after your food is digested.  As we’ve mentioned, every time you eat, your blood sugar increases and you release insulin.  When you are in a “fed state”, it is nearly impossible for you to burn fat, because under the influence of insulin you can only store fat. About five to eight hours after your last meal you enter a “fasted state”.  In this state, your insulin levels are at their lowest, and now the only energy source available is your own body fat.  So the concept behind intermittent fasting is to increase the amount of time that you are in a “fasted state”.  In a normal eating pattern of breakfast, lunch and dinner or especially in an ill-advised program where you eat several small meals a day, it is virtually impossible to reach a “fasted state”.  By reducing the frequency of your meals, you can put your body in a state of burning fat, minimize your insulin levels and dramatically improve your overall health.

What is an Example of an Intermittent Fasting Schedule?

Your life is always moving and changing.  And so can this intermittent fasting program.  This is about making it work for your lifestyle in hopes that you can realistically stick with the program.  As an example, I recently had a patient who really wanted to try Intermittent Fasting to help her lose weight.  However, as her spouse was not participating in the program, she needed to tailor her eating schedule to accommodate both their agendas.  We personalized her schedule to eat her first meal at 1pm and a second meal at 8pm so she could still have dinner with her spouse every night and go out with friends on the weekend.  This still gives her roughly 5-8 hours of fat burning in the fasted state.

What should I be eating?

You must avoid eating too many low fat, high carbohydrate meals. If you eat plenty of healthy fats (contained in foods like organic meat, fish, cheese and eggs) at each meal, you will not get hungry between meals. You must understand that your metabolism is like a fire.  You can throw small twigs onto the fire, but as quickly as you throw it on, these twigs burn up.  But if you put on a nice big log on your metabolic fire, it will burn very slowly over several hours.  Think of carbohydrates like the small twigs.  Carbohydrates burn very rapidly especially when eaten without any other type of food.  Protein and fat are the metabolic logs of your diet. These healthy and nutritious fats are slow burning fuels necessary if you want to incorporate an intermittent fasting program.

Are you interested in intermittent fasting? Come in for a consultation with Dr. Rothman by calling, 732-268-7663 and establish a better nutritional plan guaranteed to help you stabilize your blood sugars, reduce your insulin levels, improve your health, and even help you lose weight.

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