Does intermittent fasting have health benefits?

Sigh….I know! I know! It’s confusing. Every other week, a new diet approach. Keto. Vegan. Paleo. Here we go again. Bottom line is, there is no one diet fits all and part of what I do for you is give you the most up to date research available. Intermittent fasting is a new buzz phrase going around the internet health circles and to my surprise, there is no shortage of research surrounding this method of meal planning. It has definitely sparked curiosity amongst the science and health communities, particularly about its effects on obesity, insulin resistance, sleep cycles, and fat metabolism.

First, what exactly does intermittent fasting mean? Well, it’s what it sounds like….most commonly it involves a period of 2 days per week, every week, of no food whatsoever. However, some alternate days of fasting where every other day they eat and drink what they want and the opposite days they consume zero calories. And then there are some methods that specify time periods of each day where food is allowed and food is not. Usually you are allowed calorie-free fluids, but that’s it. The theory is that our body needs a “break” from food on a regular basis to produce health benefits. But what does the research actually say? These are the questions I’m going to attempt to answer.

1. Does it help with weight loss? This is really the million dollar question in my mind. I preach not to go more than 5-6 hours without eating because, after all, it actually slows your metabolism down and our bodies are designed to hoard calories when we don’t eat. Think of your body as if it were a car: food to the body is like gas is to a car. Without it, the body has no energy to move, which means the body is like a car that has run out of gas, parked on the side of the road….no fuel, nothing to burn. I’ve worked with so many clients who did not start losing weight until they started eating more often. Most drastic example I can think of is a woman who weighed more than 500 pounds and consumed only one meal per day that probably totaled to about 800 calories. She could not, for anything, lose weight. A month later, after eating double the calories, three meals a day with some snacks in between, she LOST weight. But that’s just my story, let’s look at some scientific studies.

In this small study of sixteen non-obese individuals, they lost an average of 2.5% of their starting weight after twenty-two days, so just three weeks, of alternate day fasting. However, they were HUNGRY. And that hunger never subsided. Do you think they kept at it after the study? A 5’5″ woman is technically overweight, but not obese, at 165 pounds….so if you lost four pounds in three weeks and you were starving, would you keep it at? Or find another diet, like the keto diet that is known to reduce hunger? It should be noted however that fat oxidation was increased during the study period, which means they were losing mostly fat mass and not muscle mass, this is a really good thing considering you want to keep your muscle mass when losing weight. These people did not maintain their losses, regrettably.

Here is a review highlighting several studies on alternate day fasting and comparing them to normal, calorie restricted diets (you know, the traditional method of weight loss you’ve probably tried a gazillion times.) They concluded that indeed, fasting is superior to producing weight loss and particularly, loss of fat mass. Pretty neat, huh? I’ve talked about the importance of this for preserving your metabolic rate in the past.

This last study compared individuals following an alternate day fast vs. combining it with exercise vs. exercise alone vs. a control group. These particular subjects were allowed a controlled, prepared meal that was provided for them around lunch time on the fast days. The meal was restricted to 450 calories and otherwise, calorie free beverages only. Feed days they could eat what they wanted, but they were given dietary counseling by a dietitian. Sounds pretty good, right? You may guess by now that the combo and alternate day fast group lost the most weight after twelve weeks at six and three kilograms (13.2 and 6.6 pounds), respectively. Again, most of the weight they lost was fat mass, not muscle. Awesome, right? It needs to be pointed out here though that they measured body fat using bio-impedance, which I’m not a fan of for accuracy….it’s the same kind you might use on your bathroom scale. Regardless, people are apparently losing the good kinda weight with intermittent fasting.

2. Does intermittent fasting improves insulin resistance and type 2 diabetes risk? I found lots about this one, too. The caution here if you have type 2 diabetes is that if you are taking medications that lower your blood sugar intentionally, many of the medications will not work without food OR they will work too well and cause hypoglycemia. So I’m going to begin this with an up front warning that what I’m about to say is not to be started without speaking to your doctor first if you are taking medications for diabetes. Okay?

In this pilot study (so just preliminary) on ten obese individuals, they experienced a reduction in their weight, body mass index, and fasting blood sugars after only two weeks. They fasted daily and only ate during a window of about six hours during mid-afternoon. Apparently they didn’t gorge themselves, because the article did say there was a spontaneous reduction in calorie intake measured from pictures they were required to take of all meals and food they consumed (talk about accountability!). At two weeks, this study really wasn’t long enough to say much, but six out of the ten said they would do it again.

In this study done on a small group twenty-four obese male war veterans, they did not see a significant change in fasting blood glucose or fasting lipids after six months of intermittent fasting (two nonconsecutive days a week.) Interestingly enough, their systolic blood pressures lowered and they did lose an average of twelve pounds…pretty good!

Lastly, in this review of several studies on the effects of intermittent fasting and insulin resistance, primarily reduction of type 2 diabetes risk, they concluded that the findings are showing promise for the use of alternate day fasting as an alternative to the traditional calorie restricted diets, but more research is required before solid conclusions can be reached.  I perused some of their reference articles and the theme seems to be that the results are more profound in mice than humans so far. There was another review I thought gave some really good insight and from what I gather, if you are going to try intermittent fasting for the purposes of improving your blood sugars and/or insulin resistance, focus on fasting during the evening times specifically. 

3. Does intermittent fasting help you sleep better? I bring this one up because we know that poor sleep habits lead to weight gain. So wouldn’t it be cool if there was a diet that could help you sleep better? I found two studies that looked at this. The first one was on eight volunteers who honored Ramadan, a religious period of fasting between dawn and sunset celebrated by the Islamic culture. They measured their melatonin levels via blood tests at baseline, during, and after. Unfortunately, they did not find any differences related to fasting. However, in this study, eight overweight individuals self reported better sleep when participating in time restricted fasting (food allowed <12 hours daily) for sixteen weeks. Subjective measurements are not usually as reliable, but these people obviously felt more refreshed waking up.

So what’s the verdict? Would you participate in fasting for a day or two per week or pick several hours each day to fast based on the evidence available? Seems like the information is promising, but the studies are small and preliminary. As for me, I’m not sure if I’m personally jumping on this bandwagon quite yet knowing there are other diets that are much easier to follow than this one.

P.S. If you’re looking for online support with like minded moms striving to live a healthier lifestyle, you may be interested in joining my free online support group here.

Follow me for daily livestreams on Facebook

Instagram: TheOilRD

Email: contact@jillianmcmullen.com

Jillian McMullen, RDN, CSOWM, LDN

Is weight loss surgery the easy way out?

No, no it isn’t. If you opted for weight loss surgery, don’t ever let anyone tell you that you took the easy way out. If you know someone who opted for it, realize that the decision was most likely made after hours and hours of intense thought and discussion amongst family members and key medical providers. It involves drastic lifestyle changes with a serious commitment to habit alterations. But it’s lifesaving and as I said in my recent post, it is often the best decision that person has ever made for their health.

My goal for this post is to explain the options in the simplest way possible and drive home the fact that, although weight loss surgery may be the most successful end point for weight loss known to date, it certainly is not the easy way out. It’s only a tool, but a damn good one at that.

So here we go, let’s start with the laparoscopic banding procedure. Nothing is changed from your inside anatomy. So you still have your full stomach and intestines intact. The band is purely a restrictive procedure and is just what it sounds like, a band (think of it like a bracelet even) that is placed around the top portion of the stomach. At first, it’s just a fancy expensive bracelet. Shortly after surgery, it can be filled with a salt solution, called saline, to tighten its grip around the stomach, by injecting the fluid through a port that runs from the band to just under your skin. Think of it as blowing up a doughnut ring….that hole in the middle is gonna get tighter when it’s blown up. Problem is, this procedure doesn’t work. I know, that’s a bold statement for me to say, but in the ten years I’ve worked with bariatric surgery candidates, I only saw maybe three patients (out of hundreds) lose the expected 20-25% of their initial starting weight and maintain it off for more than one year. And guess what? All of them eventually had to have their bands removed due to complications and/or weight regain. Luckily, their bands were converted to the sleeve gastrectomy and they were able to continue their lives with a more permanent option.

People see the band as the “noninvasive, less risky” choice. However, that’s just not true. When you have a foreign object placed in your body, it doesn’t like it. The band can slip out of place, corrode, grow into the stomach, get infected, flip over and out of place, the port tubing can get a hole in it and leak, and the possibilities go on and on. Most often, one of two things would happen. I either saw people throw up over and over because food just wouldn’t go down where the band was and eventually their esophagus above the band placement would dilate, or get bigger, and they would end up with essentially two stomachs to fill. Think of it like an hour glass, one on top and one on the bottom….endless hunger. Or I saw them give up and live on liquid, soft foods that slid through the band into the stomach easier…..so milkshakes, pudding, ice cream, jello, mashed potatoes, and even fried foods. It’s not uncommon for someone to even gain weight after this procedure, as you could imagine. Some facilities have smartened up and don’t offer the band anymore. In my opinion, if a surgeon recommends the band to you, run the other way.

The sleeve gastrectomy has gotten lots of attention over the past five years or so for those who have a lot of weight to lose but may or may not have any major health problems. It is a purely restrictive procedure as the surgeon removes around 75-80% of the stomach in a vertical fashion, leaving a banana shape left. Don’t be mistaken, though, your stomach ends up smaller than a banana. Think “man’s index finger” size. It is very restrictive, but what I think helps people out the most is that the part of the stomach that gets removed is also the part that produces the hunger hormone, ghrelin.

So, yea, you may fill up on the same amount of food your two year old niece just ate, but you weren’t really hungry to begin with. And if you have read or listened to any of my content before, you may have heard me talk about how ghrelin increases in production in response to massive weight loss. It can’t with the sleeve gastrectomy. That’s a big plus. I do caution people against choosing this procedure if they have problems with stress or emotional eating or what I call “grazing.” If you don’t eat because of excessive hunger and you have a habit of nitpicking all day long out of boredom or stress, this procedure doesn’t do anything to stop that….you can still eat a small amount of food every couple of hours or so. You can’t, however, sit down to a large meal and finish it in your normal ten minutes. It’s going to take at least twenty minutes to finish off a 1/3 cup of ground turkey. Talk about eating to live! Expected weight loss is anywhere from 25 to 35% of your starting weight. This is life changing for the vast majority of those that are are successful at it.

The last procedure I’m going to talk about here is the roux en y gastric bypass. This one has gotten a bad rep for years which is why I believe there are so many new procedures constantly up and coming, like the stomach stapling at one time, then the lap band, now the sleeve, and the up and coming “balloon” (that’s for another post). But this one has stood the test of time for the last forty years now and remains the gold standard of weight loss surgery. Is it drastic? Yes. Does it involve a huge lifestyle change? Oh yes. Does it work? Yes. I’ve seen lives absolutely change for the better and people leave the hospital off their diabetes medications after having this surgery. There was no waiting period for weight loss, it was immediate. When we talk about this surgery, we are talking about a metabolic operation that changes the body’s hormones with some major rerouting of your digestive system. So, like the sleeve gastrectomy, hunger is no longer an issue. Nothing is actually removed, like in the sleeve, but the part of the stomach that produces the hunger hormone, ghrelin, no longer comes into contact with food. The major difference is that a large portion of the small intestines is rerouted to create a “Y” shape with the new, smaller, egg-shaped stomach and connected lower down the digestive tract which results in calorie malabsorption. Not only are you not hungry and restricted in how much you can eat in one sitting, but you also don’t absorb all the calories you eat at one time. Lastly, high sugar and high fat foods are a no go. You run a high risk of getting sick with the shakes, diarrhea, and breaking out in sweats if you eat even just one small bite of the wrong thing. Interestingly enough, lots of people who have had this surgery experience a change in their taste preferences anyway.

Since expected weight loss is closer to 35% starting weight, I recommend this procedure for the stress eater, person with a slow metabolism, chronic yo yo dieter, and most importantly, anyone with a serious health condition who requires massive weight loss to improve. This would include cardiovascular disease, obstructive sleep apnea, or diabetes.

This is your life, and if someone told you there was a cure for a known disease that you have, would you take it? In 2013, the American Medical Association recognized obesity as a chronic disease. At that point, health insurance companies began expanding their coverage for weight loss surgeries. A chronic disease is something that never really goes away. If you have been struggling with your weight, you know what I’m talking about. You succeed at a weight loss attempt temporarily, but the weight always finds its way back, somehow. I know that this is not for everybody and you may note even qualify.

If it is something you are considering or if you are in a place where you don’t quite qualify, but you’d like some help with your weight, feel free to reach out to me at the below links.

P.S. If you’re looking for online support with like minded moms striving to live a healthier lifestyle, you may be interested in joining my free online support group here.

Follow me for daily livestreams on Facebook

Instagram: TheOilRD

Email: contact@jillianmcmullen.com

Jillian McMullen, RDN, CSOWM, LDN

Drink coffee and eat cheese to lower your diabetes risk?

It’s no secret that obesity is an epidemic in the United States and many other developed countries. Because of that, comorbid conditions that are related to extra weight are on the rise. Of particular interest is Type 2 Diabetes, a condition where your body cannot use insulin properly to regulate your blood sugar levels, causing hyperglycemia (aka high blood sugar.)

A quick science lesson to understand what’s going on in someone who has diabetes: insulin is a hormone produced by the pancreas that is necessary to move glucose (sugar) molecules into our body’s cells for energy. Every cell in the body requires glucose to function. If those glucose molecules are hanging out in the blood stream, they aren’t doing their job and instead, are creating problems like blurred vision, excessive hunger/thirst and fatigue because the body is essentially acting like you haven’t eaten. Chronically high blood sugars lead to heart disease, kidney failure, and permanent nerve damage. No organ can function correctly in a thick, syrupy-like bloodstream.

This is why prevention and management of diabetes is so important. It can absolutely be diet controlled and I’ve witnessed many individuals be able to get off of their diabetes meds with enough weight loss and diet modifications. It’s possible. But always better to not have it to begin with since diabetes is not curable. Note, I’m only referring to Type 2 diabetes here. Type 1 is genetic, usually diagnosed in childhood, and happens when the pancreas produces no insulin at all. It is unrelated to lifestyle factors. 

So what foods increase your risk? Let’s start there since more than 29 million Americans are living with diabetes, and 86 million are living with pre-diabetes. Many of those unaware. Some risk factors like age, genetics, race, and family history are out of our control. However, one thing we can do is choose what we put on our plates. Emerging research has some interesting results on just exactly what to choose and what to ditch.

Foods that increase risk:

  • refined/processed carbohydrates such as crackers, cereal, white bread, cookies, snack cakes, chips, pastries, etc. Interestingly, those marketed as “low-fat, fat-free, and low carb” are also linked to an increased diabetes risk. Why? Because they are still processed!
  • red meat (according to this study “red meat” included beef, pork, and lamb)
  • processed red meat (think bacon, hot dogs, sausage, salami, bologna, etc)
  • sugary drinks like fruit juice with added sugars, soda, fruit punch, lemonade, sweet tea, etc

Foods that have a neutral effect (at least for now):

  • butter
  • poultry (according to the research, the evidence is not clear if it increases or decreases risk)
  • 100% fruit juice without added sugars
  • eggs (can we all just agree it’s okay to eat eggs already?)
  • fish (although may decrease risk in some Asian populations)

Foods that decrease risk:

  • green leafy, vegetables
  • nuts
  • whole grains (unrefined, with the bran still intact)
  • monounsaturated fats (such as avocados, nut butters, mixed nuts)
  • high-fat dairy products (cheese, cream, whole milk, kefir, yogurt) *you read that right, check it out here
  • coffee (add some cream! who else is getting excited? It’s true, really I’m not lying to justify my addiction.)
  • tea
  • alcohol (2 drink limit for men, 1-1.5 drink limit for women, but no need to start if you don’t) *you read that right, too

Much of the research cited is from food frequency questionnaires on large scale studies. As you may know from my previous posts, this method of data collection is not the most reliable, but it’s difficult to control human behavior, especially when it comes to diet over a long period of time. Either way, I think these lists of food gives us some valuable insight on what we can control in our own life.

Lastly, remember that your diabetes risk increases after the age of 45, exercising less than three times per week, being overweight, and having a family history of diabetes. 

P.S. If you’re looking for online support with like minded moms striving to live a healthier lifestyle, you may be interested in joining my free support group here.

Follow me for daily livestreams on Facebook

Instagram: TheOilRD

Email: contact@jillianmcmullen.com

Jillian McMullen, RDN, CSOWM, LDN