Fasting without starving

By June 5, 2017 June 8th, 2017 Lifestyle & Stress, Nutrition

Many assume that fasting is a healthy activity. In some cases this may be true, but fasting can also be deadly. Ironically, we don’t have to forego healthy food to reap the benefits.

Fasting is cool. It has been for centuries, and that’s a key reason many people try it. The trend keeps coming and going. It’s difficult to say why there is such a lure; perhaps it’s the perception of discipline, the pain, the search for some mental or physical gain.

It’s difficult to answer the simple question of whether fasting is healthy because clear definitions are lacking. Confusion is a common denominator. Animal studies of fasting, versus those with humans, have different definitions and results. To summarize fasting for humans, it could be stated that common definitions include complete fasting, a state of no food, only water. The duration varies, and can be short, moderate or long periods of time. Intermittent fasting also is part of this model.

One key to understanding fasting is to first define what exactly it is — the abstinence of food, nothing but water. It’s sometimes called “periodic starvation.” But modified definitions come and go with the trends, sometimes conveniently selecting what is included or removed from a fast. The result is such things as juice fasts, or avoiding animal or dairy foods, or even alcohol. The various forms of fasting are sometimes even considered a “diet.”

Fasting can also be defined as an extreme form of dietary restriction, which entails the abstinence from all food, but not water, in a chronic manner as intermittent fasting or periodically as cycles of prolonged fasting lasting two or more days.

It’s clear who should avoid fasting. This includes children, pregnant women, the elderly, and those with cardiac and metabolic conditions.

Dangers of Fasting

Part of the problem in studying fasting’s effect on health is the inconsistent models used by people around the world. Scientific scrutiny of fasting often reveals potential negative health effects. Fasting can cause problems similar to shift working, which is associated with a wide range of disorders and diseases, due to disruption in the HPA (hypothalamic-pituitary-adrenal) axis and resulting hormone and autonomic imbalance.

A variety of unhealthy genetic changes can also occur during fasting.

Since various forms of fasting are popular in different religions, it creates a population of subjects for scientists to measure its effects. A recent study (Ajabnoor et al.) showed that during the fasting month of Ramadan, practicing Saudis develop severe disturbances in circadian rhythm, impairing sleeping, elevating the stress hormone cortisol, with increased chronic inflammation and insulin resistance. This also was accompanied by unfavorable cholesterol and triglyceride levels. Fasting may help explain the increased prevalence of overweight and obesity in Saudi Arabia — with overfat prevalence that exceeds 90 percent. This problem can lead to skyrocketing rates of cardiac and metabolic disorders, including Type 2 diabetes.

Many people are unable to fast for even short periods during the day without creating a biochemical stress. While waiting too long between meals, this stress can make some people dangerously hungry, weak and otherwise physically and mentally impaired. Forcing this situation with the notion that it will somehow help metabolism can just worsen it.

While the notion of resting the gut from a prolonged fast may seem logical, it is often done at the expense of losing the gut’s most important nutrient: glutamine, the primary fuel to keep the gut working well, especially for the absorption of nutrients. So shorter fasting for gut health makes sense, best done during the night (as mentioned below).

In another study (Brandhorst et al.), it’s emphasized that fasting could cause adverse effects that include bodywide dysfunction and even malnutrition, particularly in older and frail subjects.

Benefits of Fasting

The benefits of fasting based on scientific studies are scarce despite centuries of use. An important issue about studies showing health benefits of fasting is that it usually only includes people who are healthy. Herein lies a key fasting factor: Don’t fast unless you are healthy.

In addition — and counterintuitively — we don’t necessarily have to avoid eating to get the benefits of fasting. That’s right, you can get the same benefits without starving yourself.

Studies show that periodic fasting can cause a healthy decrease in blood glucose and insulin, improve immune function, and reduce excess body fat and weight. These are the keys to reducing the risk of cardiovascular disease, cancer and diabetes, among other chronic illness.

An important benefit of fasting is the increased levels of ketone bodies, which trigger various health benefits. This state of nutritional ketosis can be reached by eating healthy foods that reduce blood glucose and insulin — essentially obtaining all the great benefits, including ketosis, of fasting without the risks, and while maintaining nutrient balance. This is a type of “fasting” that everyone can do. It can occur without caloric restriction, without the risk of nutrient deprivation, and can have other systemwide benefits too, such as improvements in gait, reduced markers of aging, and cognitive function.

Use Food to Fast

Brandhorst et al. (2015) stated that the concerns about health impairment from fasting point to the need for dietary interventions that induce fasting-like healthy effects that minimize the risk of adverse effects, and the burden of complete food restriction. While that may sound complicated, it’s not.

Consider these two ways we can obtain fasting benefits while eating well and sleeping right:

  • Eliminate junk food and find your optimal level of natural carbohydrate foods. This will typically increase fat-burning, and raise ketone levels. Very low carbohydrate eating will further raise ketones to a state called nutritional ketosis.
  • The most effective food-free period is a daily 12-hour nighttime fast, when we sleep best. This can be done by finishing healthy eating in the early evening, then beginning the cycle again with a morning breakfast.

Rather than rely on science to tell us what’s good or bad about fasting, it’s best to find out on our own. Certainly avoiding food that causes significant negative impacts such as hunger, brain and body fatigue, poor physical performance is a step in the right direction. Eliminating these foods for an extended period of time — maybe even forever — can provide many of the health benefits of fasting without the possible negative consequences.

 

References

Ajabnoor GM, Bahijri S, Shaik NA, et al. Ramadan fasting in Saudi Arabia is associated with altered expression of CLOCK, DUSP and IL-1alpha genes, as well as changes in cardiometabolic risk factors. PLOS ONE. 2017;12(4):e0174342.

Brandhorst S, Choi IY, Wei M, et al. A periodic diet that mimics fasting promotes multi-system regeneration, enhanced cognitive performance, and healthspan. Cell Metab. 2015;2:86–99.

Persynaki A, Karras S, Pichard C. Unraveling the metabolic health benefits of fasting related to religious beliefs: A narrative review. Nutrition. 2017;35:14–20.

6 Comments

  • john durmick says:

    oh yeah, forgot to say, I also use the MAF heart rate training approach with great success! -jd

  • john durmick says:

    I’ve been doing a 36 to 40 hour water and some coffee fast every week for many years. Otherwise I eat low-ish carb, high-ish protein, healthy fat, minimal grass seed (grain), some starch but not all that much. In all the years of doing this I have never experienced hunger during a fast, but I also don’t do extended fast, just the 40 hours. The low carb/no grain rule seems to mitigate cravings (non-hunger desire) as well, as I really don’t have those either. More importantly, I am fully active on fasting days with no negative impact and indeed, I experience enhanced physical energy and emotional and mental clarity on the fasting day.

    I have never experienced a negative effect from fasting and suggest that those that do are in fact experiencing side effects from carbohydrate withdrawal, not from fasting per se.

    Right now, CAC score (calcium/plaque in the heart/vascular system) is zero (no plaque), just had colonoscopy and 100% clear of issues, lipid numbers are superb, insulin sensitivity is high (tri/hdl < 1), etc, etc. All of those are profound improvements over the "before fasting" reports.

    And I agree with Jerry above that Jason Fung is a fount of knowledge and wisdom in this area. He is in fact my most trusted advisor, although I have not yet met him face to face.

    I retired from marathons but still do halfs, I am active in senior olympics track and field, avid cyclist and do extensive body weight exercise like pull-ups, push ups and handstand pushups. I am very well fat adapted (body fat for fuel) and do not carb load for endurance exercise.

    Body fat is low and belly is flat. I lost 40 pounds on this approach in 6 months over 6 years ago and have maintained that loss effortlessly since. I am 6'1 and 180; 66 years of age.

    My point: Fasting is a valuable, powerful healing (and probably longevity) strategy if and when the diet is otherwise minimally damaging. I think it is pretty useless if you are downing a lot of carbs, though. It is not deprivation at all, it is completely natural and our evolutionary biology was designed around inconsistent food availability so I see not eating as a very fundamental core competency of humans, certainly not a risky/dangerous behavior.

  • I’d recommend Jason Fung’s “The Complete Guide to Fasting.” He previously wrote “The Obesity Code,” which contained a short chapter on fasting, focusing on intermittent fasting. “Complete Guide” goes into more detail and has the research.

    He points out that fasting — voluntary or involuntary periods of food deprivation — has been a part of the human experience until very recently.

    In fact the “Mediterranean” diet — that seems to uniquely receive praise from across the spectrum of dietary advocates — was likely only part of the lifestyle of the small Greek island that resulted in such noticeable health and longevity outcomes. A large (but ignored by most) part according to Fung was that the population during the time the were studied were devout Orthodox Greeks, the observation of which involves fairly regular fasting throughout the year.

  • blake says:

    Yeah, the Ramadan fasting seems particularly weird, since they don’t drink water, and it’s only during the day. It’s like a reverse of the fast you do just by sleeping.

    I’ve been fasting a lot lately. I’m glad there’s some science to back it up because mostly people get alarmed when they say you’re not eating. But I feel good and (people say, even though they’re alarmed when they find out why) look good. It’s easy, too. Eating seems to be more a habit than anything. Most of my eating these days is social.

    Also, as for nutrition, there’s a cost to metabolism which is not incurred if you fast. This may explain reports of (e.g.) teeth healing during a fast.

  • Dan says:

    If only the researchers knew how Saudis and Muslims in general break their fast during Ramadan. Think loads of carbs (rice, bulgar wheat etc), fat, red meats and lamb and an assortment of sweet pastries for desert, accompanied with sweetened tea and coffee. Do that night after night for that long and you too will develop all kind of illnesses. Personally, I can no longer eat in the morning (maybe coffee) so in essence I routinely fast for 16 hours.

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