Intermittent Fasting Wave — Do You Need To Catch It?

urlYou have to close your eyes really tight to miss the intermittent-fasting (IF) wave going on right now. Every major newspaper, magazine and television show has mentioned something about IF. Newly-released books about it are touting IF as the obesity cure. According to some websites IF will help with weight-loss, cancer, insulin-sensitivity and immune function just to name a few. Is IF the second coming? Is this latest diet wave one you should catch? In this article I’ll discuss what IF is and isn’t and provide you with plenty of opportunity, if you have more time than you know what to do with, to dig further to your heart’s content.

Both ABC and NBC recently had reports on some version of IF. Here’s the teaser …

Wellness expert David Zinczenko chats with Access Hollywood Live’s Kit Hoover and guest co-host Willie Geist about his new book, “The 8-Hour Diet.” How does this diet help you to quickly lose the unwanted pounds while still eating whatever you want?

Here’s the newest coverage from ABC’s Good Morning America on the “Fast Diet” by Dr. Michael Mosley. Mosley is making the rounds right now promoting his book.

Here’s Mosley on the Today Show

This isn’t my first review of IF but it is my attempt at being a bit more in-depth with it. A while back I reviewed John Berardi’s self-trial of IF and you can read about that HERE. IF is on a meteoric rise and I owe it to my readers to provide my perspective. So I’m going to briefly review what I’ve been able to find on IF and then leave you all to make your own decisions about it.

What exactly is IF? It’s when you don’t eat or drink calories for a period of time – like what happens when you go to sleep at night. I believe IF is a fad diet even if it does end up staying around a long time. I predict it will rise rapidly to a certain level of fame and then fade quickly once the perception of novelty has worn off. I believe it will follow the likes of the Atkins Diet. The Atkins Diet is still around. People still do it. But it’s nothing like it was five or ten years ago when it too achieved cult-like status with legions of loyal followers swearing it was THE answer for them and the next cure for obesity.

IF research is still in its infancy even though it’s climbed in popularity over the last 10 years. And most research is on rodents—not humans. Rodents are cool for studies and we can learn a great deal from these studies. But until humans are the “guinea pigs” all things being touted in support of IF where rodents were used must be taken with a grain of salt.

One study published in Nutrition Journal 2012, 11:982012 was titled “Intermittent fasting combined with calorie restriction is effective for weight loss and cardio-protection in obese women.” Well that sounds promising. In their study they reference the only two other human studies they could find that involved IF and weight loss. In one study women were put on an IF diet for 24 weeks. They lost about 7% of their starting body weight — in 24 weeks. That means a 200 pound person lost 14 pounds in 24 weeks. The authors state “Though these findings are promising, this regimen is limited in that a long duration of time (i.e. 24 weeks) is required to experience only modest reductions in body weight.” In the other study researchers had people eat less than 500 calories a day one day a week and then whatever they wanted the other six. After 20 weeks participants lost 9% from baseline. So a 200 pound person lost 18 pounds in 20 weeks. It’s better than a poke in the eye with a sharp stick. But I’m not thinking I want to jump in the deep end, catch the wave or go all in with these results.

I promise this will be my only shameless brag in this article but my 20-week Lifestyle180 course offered in February of each year, produces on average, an 18% reduction in body weight. So on average, a 200 pound person loses 36 pounds in my 20-week program.

The authors of the 2012 study decided they would combine calorie restriction six days a week with one day of fasting and see how that works. In addition they decided to throw in a group that would also get liquid meals for two of their three feedings for the day. Sound familiar? Sounds like the old Slimfast diet. Drink two shakes a day and have one healthy meal and you’re set. The only difference here is the authors decided to make one of the seven days in a week be a fasting day.

So what happened? After eight weeks of treatment, with some of the participants doing the Slimfast-like diet and some participants using all real food, the results were “modest.” The Slimfast-like diet participants lost 4.1% of their starting body weight and the real-food dieters lost 2.6%. The authors stated they believed the Slimfast-like dieters did better because the liquid meals made it easier to adhere to the calorie restriction without them having to think about it. This isn’t new. It’s the entire basis for the Slimfast dieting model. They know people hate to think about anything so they make it as brainless as they can for the user. The problem is the results are short lived. No one eats two shakes a day plus one healthy meal for life. Once the follower starts eating three or four real-food meals a day the wheels come off the bus. For everyone? Nah, just 80-95%. But don’t take my word for it. Here’s what the authors had to say …

“Although these liquid meals are effective for helping with initial weight loss, lasting weight loss and weight maintenance requires extensive dietary counseling to instill healthy behaviors that can be employed long-term.”

Even with few human studies, this hasn’t stopped IF from reaching cult-like status and mythical proportions in certain Internet neighborhoods. The problem with most sites promoting IF and that have a loyal following is there simply is no good way to know who’s absolutely full of doo doo and who is actually benefiting.

So often when the new kid gets on the block people try it and within 10 days are SURE it’s the right diet for them because they’ve “already lost six pounds.” One of the many problems is we rarely hear from and almost NEVER actually see these individuals days, weeks or months later. What happened after the lustful Monday through Thursday romp in the sack? Are the excited “just lost six pound” users still enamored with their new diet love? More times than not we never know. New is exciting! At first it’s roses, cards and wild sex hanging from the chandelier but like a torrid love affair, with time, the realities of long-term sustention come into play. That’s when you figure out the diet has smelly feet and bad breath. It’s a friggin diet and you ultimately have to figure out if it’s someone you want to spend the rest of your life with—smelly feet and all. If not? Why continue the relationship? Wait, where was I? Oh yes the mythical proportions of IF.

A traditional fast is typically thought of as an “all-day” fast. If you’re awake 16 hours you won’t eat and may only consume water or perhaps some diluted juice during the fast. IF, on the other hand, is achieved any time you wait to eat until the post-absorptive state—that is until the nutrients from your last feeding have been absorbed—about 3-5 hours after consumption. Most people participate in IF every time they go to bed and sleep at least five hours. Many of those same people participate in IF at one or more times during the day when they wait 3-5 hours to eat their next feeding. IF has become such a rage in certain corners that the “fasting” part of IF has really gotten bastardized in my opinion. People so want to participate in hopes of a weight-loss miracle. A part of the miracle they hope for is not really changing what they eat, when habits and intake are considered, over a one- to two-week period. “So you mean if I wait at least five hours I can benefit from IF?” In some Internet neighborhoods there will be a resounding “Yes!” as the answer. I think the more appropriate answer would be “You can participate in the IF craze by waiting at least five hours between feedings. Whether you benefit or not will depend on your level of nutritional excellence—the same for any viable, legitimate, sustainable weight-management program.”

With IF you may eat fewer times per day than you’re used to. You may not. It depends. Remember, IF is INTERMITTENT fasting. So if I wait at least five hours to eat I have participated in IF. That doesn’t mean my total feedings in a day will be less than my norm. But for some—that’s exactly what it means. There are a percentage of non-stop grazers out there who rarely go an hour without eating or drinking something. If this describes you then I encourage you to reel it in to a total of 3-6 feedings/drinkings during the day. Wait at least three hours between eating or drinking anything other than water. By doing so you may reduce total caloric intake (may not) and take some of your attention off of food and away from the next bite. If IF helps you to do this by shifting your paradigm and habits for meal frequency then so be it. But unless you adjust the quality of the food you eat there’s no guarantee you’ll see improvements in health or weight through this reduction in meal frequency.

According to Berardi several popular IF programs have emerged. I guarantee you this is only the tip of the iceberg for what’s to come. There’s the Alternate-Day Fast. You basically eat every other day. Then there’s the Eat Stop Eat plan. With this plan you simply don’t eat a couple times a week. Next comes the LeanGains plan. With this IF method you eat for eight hours and fast for 16. If you aren’t already shredded-wheat lean just hearing of those diets then maybe the Warrior Diet is what you need. With this plan you fast for 20 hours and then OVER-feed for four. Ooooh did some sugar-high bells and whistles just go off in your head? You get to OVER EAT! There’s just that nagging little catch though where you have to eat essentially nothing for 20 hours. Last comes Meal Skipping. You get your IF badge by simply skipping meals. You ate breakfast at 6am, you skipped lunch and waited for dinner. Congratulations! Your now a member of the IF family. You’re hip, cool and all the chicks love you. I doubt you’re any leaner or healthier but at least you’re in the club.

I’ve already said that IF might be a method to help the constant grazers to reel in their eating frequency. Might anyone else benefit? Might eating fewer meals in a 24-hour period result in fewer calories too? Sure. Then again maybe not but yes it can happen. Might eating fewer meals in a 7-day period create the same benefit? Yes, and then again, maybe not, it depends. But if someone is used to eating all day long and isn’t conscious about what they’re eating then perhaps thinking of meal spacing with an IF paradigm can help.

But IF is not a one-sex fits all. From research and reports in the blogosphere there appears to be a gender bias with men experiencing more benefit and fewer side effects than women. According to “PaleoForWomen” blogger Stefani Ruper …

Many women find that with intermittent fasting comes sleeplessness, anxiety, and irregular periods, among a myriad of other symptoms hormone dysregulations. I have also personally experienced metabolic distress as a result of fasting, which is evidenced by my interest in hypocretin neurons. Hypocretin neurons have the ability to incite energetic wakefulness, and to prevent a person from falling asleep, should his body detect a “starved” state. Hypocretin neurons are one way in which intermittent fasting may dysregulate a woman’s system.”

She goes on to say …

“It is well-known in both the research and the nutritional communities that caloric restriction is horrible for female reproductive health. This is not news. But what of fasting regimes? Should women go long periods without eating, even if maintaining normal caloric input? The few studies that exist point towards no.”

If you’re female then I strongly urge you to go read Stefani’s blog on this subject here. IF has also been shown to exacerbate already-stressful periods. The potential negative impact of being female and fasting appears credible. She has a LOT more to say on this subject and references everything. Click Here To Read More On Her Blog

I discussed this a bit in my original review of IF but it’s worth noting again. The “hook” if you will for many people who may decide to try IF is that they believe they will get to eat all the crap they normally do, and for that benefit, will just have to choose some periods where they don’t eat at all. This can seem very appealing to our food-addicted brethren. Many people would rather face a firing squad than the thought of not having multiple “hits” from their favorite socially-acceptable drug–food. The reality, however, is unless dietary and behavioral changes occur beyond meal frequency no lasting success will occur.

In marketing there’s an axiom that goes “Sell them what they want. Deliver what they need.” Right now there are entrepreneurs who see dollar signs with IF. They will say and do anything to get people to bite and buy. Then once the buyer is in they have to break the “bad” news to them. Guess what? Changes are going to be necessary in the quality of the foods you consume or this ain’t gonna work. And that’s when the audible sighs are heard around the world from new buyers.

Many of the internet plans and diet books being promoted make it sound like you eat anything you want when you’re eating and the only price you pay are those intermittent periods of fasting. This won’t work for most in the short-term let alone for permanent weight loss. And a reality that few talk about is most chronically-overweight people are either food addicted or compulsive overeaters. Tell a food addict or compulsive overeater they get periods when they get to eat anything they want? Watch out – the pleasure centers of the brain light up and the addiction and compulsion are fed. This doesn’t help the addict or compulsive overeater–it perpetuates their misery and suffering.

Just as there are unscrupulous entrepreneurs there are also those who will tell most of the truth upfront. Perhaps they found, for them, that IF helped them to become more conscious overall about their nutrition quality and overall fitness program with an accompanying shift in 24-hour energy balance in favor of fat loss. So they tell others of the way THEY did it and they even advise of nutritional shifts that will be necessary or are at least suggested. Those suggestions are often overlooked or ignored. What the new reader may see is what they want to see. “This is a new diet. Others are raving about it. I get to eat what I want and all I have to do is shift my meal frequency around a little bit. I can do that!”

If you decide to read on the subject of IF you could literally waste an entire weekend just reading online literature and blogs. I’m going to do my best to summarize what I’m seeing as of March 2013 so you can get on with your lives rather than the tedium of chasing this rabbit down its hole.

In Summary

  • IF is when you go without caloric consumption for at least 3-5 hours.
  • IF, in my opinion, is a fad and will follow the likes of the Atkins diet
  • Research with humans using IF for weight loss are few
  • Available research indicates modest results at best
  • IF may be a method to increase consciousness if you haven’t been taught other methods
  • IF may or may not be a method to reduce 24-hour energy intake
  • IF programs, if remotely reputable, all promote food quality first
  • IF will require dietary and behavioral changes for lasting success
  • IF may make already-stressful periods worse both hormonally and behaviorally
  • IF may promote bingeing and feed food addiction and compulsive overeating

In health,

David Greenwalt

Addendum – Added 09/17/2013

A thought came to mind today as I was doing my daily perusing of my health and fitness news sources. The truest test of whether IF is the best “diet” for stripping fat and keeping-adding muscle is whether professional bodybuilders end up embracing it en masse.

Professional (drugged), or even top-tier natural bodybuilders, are great groups to watch in the coming years re: intermittent fasting. After all, although small in number, professional bodybuilders earn most or all of their living being bodybuilders. That is they earn their living packing on the maximum amount of muscle they can and being the leanest they can possibly be. Being the best in the world, regardless of sport, at maximizing muscle gains and leanness, bodybuilders have the most to lose or gain depending on what diet they choose. I see this as being important for the everyday person because at much smaller levels all of us want SOME muscle and we want SOME level of leanness even though we don’t want the professionals’ level of either.

In the 90s Atkins and/or a variety of ketogenic dieting + refeeds were allegedly God’s gift to bodybuilders. That is until professional bodybuilders tried them and didn’t get as lean or feel as good during the get-lean process. Then, by and large, top bodybuilders went back to a non-ketogenic diet for both lean-body-mass gains and fat stripping.

If intermittent fasting confers equal or better benefits for adding lean-body mass or if intermittent fasting confers equal or better benefits for stripping fat while preserving lean-body mass (when compared to the 4-6 meals of low-moderate carb, high protein, low-moderate fat) then we should see an onslaught of professional bodybuilders (not onesie twosie) also kneeling at the alter of and hailing intermittent fasting as king of the diets. After all, as I’ve said, like it or not, no human being on earth has more to gain than a professional bodybuilder when it comes to optimizing lean body mass with maximum leanness.

If intermittent fasting IS better then those who have the most to gain from using it WILL use it and it’ll become the new diet standard. Professionals will move somewhat slowly towards this unless those at the very top make it known that it works better and their stage presence proves it so.

I don’t think we’ll have the answer for a year or two but within two years it’ll either be embraced by the pros or it won’t. If it isn’t embraced then, like any diet, intermittent fasting (waiting at least 5 hours between feedings? how do you want to define it?) will provide some utility for a segment of everyday people wanting to lose fat and/or preserve-gain muscle but it’ll be no more a darling of the diet world and blogosphere than Atkins or ketogenic dieting is today.

My prediction? Exactly that. IF is a fad, it’ll be harmful for some, neutral for some, beneficial for some. Time will tell. It’s go to play itself out.