To Your Health With Dr. Jim Morrow: Episode 25: Intermittent Fasting

On this edition of “To Your Health with Dr. Jim Morrow,” Dr. Morrow discusses the current intermittent fasting trend and healthy ways to approach dieting in this fashion. “To Your Health” is brought to you by Morrow Family Medicine, which brings the CARE back to healthcare.

About Morrow Family Medicine and Dr. Jim Morrow

Morrow Family Medicine is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Morrow Family Medicine one that will remind you of the way healthcare should be. At Morrow Family Medicine, we like to say we are “bringing the care back to healthcare!” Morrow Family Medicine has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

Dr. Jim Morrow, Morrow Family Medicine, and Host of “To Your Health With Dr. Jim Morrow”

Dr. Jim Morrow is the founder and CEO of Morrow Family Medicine. He has been a trailblazer and evangelist in the area of healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce. He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

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The complete show archive of “To Your Health with Dr. Jim Morrow” addresses a wide range of health and wellness topics, and can be found at www.toyourhealthradio.com.

Dr. Morrow’s Show Notes

If you thought fasting was just for religious purposes, think again.
- A newer phenomenon in the weight loss world called Intermittent Fasting (IF) is growing into a popular health and fitness trend.
- During IF, you alternate between periods of eating and fasting. This type of eating is often described as “patterns” or “cycles” of fasting.
- There are several effective approaches to IF, but it all comes down to personal preference.
Some people find it easy to fast for 16 hours and confine meals to just eight hours of the day, such as 9 a.m. to 5 p.m., while others have a hard time and need to shorten their fasting window.
But is intermittent fasting good for you?
- While some researchhas shown the benefits of IF, such as weight loss, lower blood pressure and improved metabolic health, more investigatioxan is still needed, especially regarding long-term outcomes of IF.
- There is also the aspect of sustainability.
  - Severely restricting calories or not eating for long periods at a time isn’t for everyone.
  - Some researcheven shows that those who do intermittent fasting don’t usually stick with it as compared with those trying to lose weight on more traditional diets.

Still, IF has been shown to be an effective form of weight loss – but so have other options like eating a well-balanced diet paired with exercise.
- One studysuggests that IF is not more effective at supporting weight loss or improving blood sugars than other well-balanced approaches.
If you want to try IF, you’ll first need to figure out how you are going to incorporate this style of eating into your life, especially when it comes to things like social events and staying active.
Ready to explore your options?

The twice-a-week method – 5:2
- This approach to IF focuses on capping your calories at 500 for two days a week.
- During the other five days of the week, you maintain a healthy and normal diet.
- On fasting days, this approach usually includes a 200-calorie meal and a 300-calorie meal.
- It’s important to focus on high-fiber and high-protein foods to help fill you up, but to also keep calories low when fasting.
- You can choose whichever two fasting days (say, Tuesdays and Thursdays) as long as there is a non-fasting day between them.
- Be sure to eat the same amount of food you normally would on non-fasting days.

Alternate day fasting
- This variation involves “modified” fasting every other day.
- For instance, limit your calories on fasting days to 500 ― or about 25% of your normal intake.
- On non-fasting days, resume your regular, healthy diet.
  - (There are also strict variations to this approach that include consuming 0 calories on alternate days instead of 500.)
- Interesting finding of note:
  - One studyshowed people following this pattern of IF for six months had significantly elevated LDL (or bad) cholesterol levels after another six months off the diet.

Time-restricted eating (example: 16/8 or 14/10 method)
- In this option, you have set fasting and eating windows.
- For example, you fast for 16 hours of the day and are able to eat for only eight hours of the day.
- Since most people already fast while they sleep, this method is popular.
- It’s convenient as you extend the overnight fast by skipping breakfast and not eating until lunch.
- Some of the most common ways?
  - 16/8 method:Only eating between 11 a.m. and 7 p.m. or noon and 8 p.m.
  - 14/10 method:Only eating between 10 a.m. and 8 p.m.
- This method of IF can be repeated as often as you’d like or even done once or twice a week – whatever your personal preference is.
- Finding the right eating and fasting windows for this method might take a few days to figure out, especially if you’re very active or if you wake up hungry for breakfast.
- This form of fasting is a safer bet for many people who are interested in trying IF for the first time.

The 24-hour fast (or eat: stop: eat method)
- This method involves fasting completely for a full 24 hours.
- Often times, it’s only done once or twice a week.
- Most people fast from breakfast to breakfast or lunch to lunch.
- With this version of IF, the side effects can be extreme, such as fatigue, headaches, irritability, hunger and low energy.
- If you follow this method, you should return to a normal, healthy diet on your non-fasting days.

Intermittent fasting is not a magic pill
- Whether you are doing IF, keto, low carb, high protein, vegetarian, the Mediterranean diet– you name it – it all comes down to the quality of your calories and how much you’re consuming.
- The bottom line with IF? Although the jury is still out and long-term effects are still being studied, it’s crucial to eat a healthy, well-balanced diet while following IF.
- You can’t eat junk food and excessive calories on non-fasting days and expect to lose weight.

Side effects & risks
- Intermittent fasting is not safe for some people, including pregnant women, children, people at risk for hypoglycemia, or people with certain chronic diseases.
- If you’re at risk for an eating disorder, you shouldn’t attempt any sort of fasting diet. IF has also been known to increase the likelihood of binge eating in some people because of the restriction.

If you’re interested in trying IF, you should also be aware of some not-so-pretty side effects.
- IF can be associated with
  - irritability,
  - low energy,
  - persistent hunger,
  - temperature sensitivity and
  - poor work and activity performance.

Where to start?

Consider a simple form of IF when starting out.
- Start with a more moderate approach of time restricted eating,
- Start by cutting out nighttime eating and snacking and then start to limit your ‘eating window’ each day – such as only eating from 8 a.m. to 6 p.m.
- As you progress and monitor how you feel, you may choose to gradually increase your fasting window.

What is Autophagy?

In 2016, Japanese cell biologist Yoshinori Ohsumi won the Nobel Prize in Medicine for his research on how cells recycle and renew their content, a process called autophagy.
- Fasting activates autophagy, which helps slow down the aging process and has a positive impact on cell renewal.

During starvation, cells break down proteins and other cell components and use them for energy.
- During autophagy, cells destroy viruses and bacteria and get rid of damaged structures.
- It’s a process that is critical for cell health, renewal, and survival.

Ohsumi’s Work

Ohsumi created a whole new field of science with his work studying autophagy in yeast.
- He discovered that the autophagy genes are used by higher organisms including humans, and that mutations in these genes can cause disease.
- Animals, plants, and single cell organisms rely on autophagy to withstand famines.

Although first discovered in the 1960s, Ohsumi’s research from the late 1980s and early 1990s through today has shown autophagy has a role in protection against inflammation and in diseases like dementia and Parkinson’s.
- When Ohsumi started researching autophagy, there were fewer than 20 papers published each year on the subject; now there are more than 5,000 each year, as it is the subject of diverse fields including cancer and longevity studies.

Fasting for Health

Scientists have found that fasting for 12+ to 24+ hours triggers autophagy, and is thought to be one of the reasons that fasting is associated with longevity.
- There is a large body of research that connects fasting with improved blood sugar control, reduced inflammation, weight loss, and improved brain function;
- Oshumi’s research provides some of the “how” to this research.
- Exercise can also induce autophagy in some cells, allowing cells to start the repair and renewal process.

Myths About Intermittent Fasting

Myth 1: Intermittent fasting is a starvation diet
- Fact: You won’t starve if you skip a meal — or even if you fast for 24 or 48 hours.
- Research suggests you have to fast more than 60 hours straight before your resting metabolic rate drops.
- In fact, one study showed this rate increased from 3.6 to 10 percent after 36 to 48 hours of fasting.
- We humans know how to fast.
  - It’s helped us survive famines for centuries
  - But starvation is something different.
    - It’s defined as suffering or death caused by hunger.
    - In starvation, your fat stores are depleted, so your body must break down muscle tissue for energy.
  - In intermittent fasting, your body releases energy stored as fat — and muscle and lean tissue are spared.
    - So unless you’re constantly running marathons and have fat levels below 4 percent, intermittent fasting won’t affect lean tissue — as long as you do it correctly and work with a dietitian or physician.
  - Another reason you’re unlikely to starve is that an alternating pattern of eating and then fasting is beneficial.
    - In one study, animals that feasted on fatty foods for eight hours and fasted for the rest of the day did not develop obesity or dangerously high insulin levels.
  - Myth 2: You’ll be hungry all day long.
    - Fact: Research shows that on fast days, hunger can actually decrease.
    - By the second week of intermittent fasting, obese individuals experienced less hunger, and their hunger remained low.
    - Other research shows that eating enough calories on non-fasting days is actually more of a struggle than hunger.
  - Myth 3: On off days, you can eat whatever you want.
    - Fact: You won’t lose weight on a fasting diet if you exceed your maintenance calories on off days.
    - On off days, you still follow a healthy eating pattern, but you don’t need to restrict yourself to a specific number of calories.
    - I suggest that my patients listen to their hunger, rather than measure and limit.
    - To keep from overeating, eat a balanced diet that includes fruits, vegetables and whole grains. I
      - f you don’t have dietary restrictions, consider lean meats, poultry, fish, beans, eggs and nuts.
    - But focus on real foods.
      - Avoid processed products, and don’t be fooled by “healthy” or “organic” marketing claims.
      - Scan the ingredients list on every label for refined carbs, hidden trans fat, chemicals and added sugars.
    - Myth 4: Once you start an intermittent fasting plan, you’re stuck doing it for life.
      - The beauty of intermittent fasting is that it alters your cravings and hunger.
      - So after you’ve gone without that midnight snack of potato chips or licorice long enough, you’ll eventually no longer want it — without having to work hard to not want it.
      - The key is training your taste buds to love good food and to reject the foods most likely to lead to weight gain and chronic disease.
      - Ready to try intermittent fasting?
        
        Now that you’re armed with the facts, you’ve got a much better chance of success.