By Dr. Deb Rivera
"A Non-Traditional Diet" by Dr. Debra Rivera
For the past few months, I have written about different weight loss systems. Today we will close out the series with an effective but somewhat controversial diet system--fasting.
Fasting is the restriction of food and water for a period of time. Dating back thousands of years, fasting was practiced for religious reasons. In present time, it has become a tool for weight loss (Wai, 2017). Long-term fasting takes the form of "dry fast," no food or water whatsoever, and water fasting (drinking water without the consumption of calories) (Paleo Leap, 2018). Long fasts will nudge weight loss fairly quickly. The body uses glycogen from your liver and then whatever has been stored (protein or fat). Eventually, the body goes into ketosis and must rely on fat. While long fasts are effective for losing weight, the downside is that dieters tend to regain what they have lost once they discontinue the system (Paleo Leap, 2018). For this reason, weight loss experts recommend intermittent fasting instead.
Intermittent fasting is a system that involves cycling between periods of eating and periods of abstaining. Within this system is several approaches, including "5:2" dieting--eating 500-600 calories for two days of the week and eating as desired on the other five days. Next, is time-restricted feeding, when calorie consumption takes place within a 3-12 hour window. Lastly, is a regimen of alternating 24-hour fasting periods (no food) with non-fasting periods (no restrictions on what can be consumed) (Drayer, 2018).
Although intermittent fasting is being touted among celebrities (Nicole Kidman, Beyoncé, Hugh Jackman, and Ben Affleck have all had success using this method) (Drayer, 2018), experts point out that alternate-day type fasting does not produce exceptional weight loss when compared to daily caloric restriction diet systems (Trepanowski, Kroeger, Barnosky, Klempel, Bhutani, Hoddy, Gabel, Freels, Rigdon, Rood, Ravussin, & Varady) (2017).
According to Wai (2017), starvation or extreme caloric restriction diets poses risks. These include: a plummet in blood pressure and/or blood glucose levels, increased chance of getting gallstones, thinning skin, hair loss, and decreased metabolism (therefore less muscle mass). Instead of risky starvation or caloric restriction plans, Wai (2017) suggests the following triad approach: behavior modification (goal setting, social support, enlisting a food diary to track eating behavior); exercise (combining aerobic activity with resistance training for a minimum of 30 minutes per day); and specified diet formula (ones that are low in unhealthy fats, high in protein, and are low calorie, and emphasize complex carbohydrates rather than simple carbohydrates). Simply put: eating more brown rice and less soda.
On the flip side of experts such as doctor(s) Wai (2017) and Trepanowski et al (2017), is Dr. J. Fung (2016), who made waves in the medical and health arena when he proposed using fasting instead of calorie counting to facilitate weight loss. Fung (2016) claims that portion control does not work and has about a 99.5% failure rate! The culprit within this type of diet plan? Metabolic slowdown. When metabolism dips, weight loss plateaus. A reduction in calories forces the body to shut down in order to match a lowered caloric intake. Though caloric restriction systems seem effective, they only work short-term.
Fung (2016) explains that long term weight loss involves maintaining basal metabolism. Basal metabolism is the basic amount of energy your body requires to survive when you are at rest (Busch, n.d.). Interestingly, Fung claims that controlled starvation (think intermittent fasting) does not actually "starve" the body, but instead triggers hormonal adaptations (something that does not occur in caloric reduction systems). This is how it works: insulin drops, aiding in preventing insulin resistance; growth hormones increase, helping to maintain lean mass, and noradrenalin elevates, keeping metabolism high. Furthermore, Fung (2016) maintains that obesity is not a hormonal imbalance, rather it is a caloric one. Fasting supplies beneficial hormonal changes that does not occur during the constant intake of food. Fung contends that calorie-restricted diets disregard the biological principle of homeostasis (the body's ability to adjust to a changing environment). He likens this to our eyes and their ability to adjust to a dark room or bright light. Much in the same way, this can also apply to weight loss--that is, a body adjusts to constant dieting by slowing metabolism, thus becomes ineffective for weight loss.
Fung's (2016) findings are in direct contradiction to other diet experts who recommend caloric reduction as a primary weight loss system. Fung points out that fasting has been used throughout history as a method for controlling obesity. However, the portion-control method of daily caloric restriction has only been in effect for about 50 years. Fung states that promoters of caloric restriction methods tend to ignore fasting studies and its successful trials. These details such findings as: truncal fat loss (considered to be dangerous visceral fat) is less likely with fasting as opposed to caloric reduction; lean mass is preserved; and that ghrelin (the hunger hormone) increases with caloric reduction, but not during a fasting cycle. Fung states that it is no coincidence that most people tend to be hungrier during the diet phase and it is not a willpower problem, but rather a hormonal problem--ghrelin increases, therefore an individual is hungrier--something that does not occur when fasting.
While the pundits for caloric reduction continue to defend their weight loss method, Fung's (2016) fasting plan has at least one other medical expert in his corner. Dr. T.S. Arab (2017) states that fasting is superior to traditional calorie counting, citing not only Fung's findings, but adding these as supporting evidence: fasting reduces LDL levels (the 'bad' cholesterol); it induces autophagy (when the body digests and rids itself of cell remnants, i.e., waste disposal) and which has been linked to neuroprotection; and reduces inflammatory mediators (thereby protecting the body against autoimmune diseases).
Until we have proven, scientific evidence that rings true in every case study involving these two types of diet systems, the caloric reduction system versus fasting for weight loss debate will rage on.
Until next time, I leave you with this: "It's called DIET because all the other four-letter words were taken."
Arab, T.S. (2017). Sound science backs fasting. Calorie counting can’t compete.https://health.spectator.co.uk/sound-science-backs-fasting-calorie-counting-cant-compete/
Busch, S. (n.d). What is basal metabolism? http://healthyeating.sfgate.com/basil-metabolism-8850.html
Drayer, L. (2018). How to succeed at intermittent fasting.https://www.cnn.com/2018/03/23/health/intermittent-fasting-food-drayer/index.html
Fung, J. (2016). Why fasting is more effective than calorie counting. https://www.dietdoctor.com/fasting-effective-calorie-counting
Paleo Leap. (2018). Long fasts: Dangerous or beneficial? https://paleoleap.com/long-fasts/
Trepanowski, J.F., Kroeger, C.M., Barnosky, A., Klempel, M.C.,Bhutani, S., Hoddy, K.K., Gabel, K., Freels, S., Rigdon, J., Rood, J., Ravussin, E., & Varady, K.A. (2017). Effect of alternate-day fasting on weight loss, weight maintenance, and cardioprotection among metabolically healthy obese adults. JAMA Internal Medicine, 177 (7), 930-938. doi: 10.1001/jamainternmed.2017.0936
Wai, D. (2017). Weighing the benefits of fasting diets.https://www.mountelizabeth.com.sg/healthplus/article/weighing-the-benefits-of-fasting-diets
By Jennifer Lawson
At The New Floridian, we've had a lot going on. We've had plenty of blog posts that have been of interest.
This month, I want to turn your attention to Earth Day--April 22. The focus this year will be mostly on the reduction of plastic pollution. You can cut down your plastic pollution by saying 'No' to plastic straws when you go out to eat and bringing your own bag when you go grocery shopping.
This is our planet to share. Together, we can preserve it.