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The Promise of The Promise of Intermittent Fasting: Intermittent Fasting: Case Study Case Study

Married, mother of 3 childrenMarried, mother of 3 children

Struggled with weight gain most of her lifeStruggled with weight gain most of her life

Diets failedDiets failed

FatigueFatigue

Exercise failedExercise failed

Flare-ups of rosacea and irritable bowel Flare-ups of rosacea and irritable bowel syndromesyndrome

December 2010December 2010 May 2013May 2013

How C.M. Transformed How C.M. Transformed Herself Herself

Intermittent fastingIntermittent fasting

Key nutrients Key nutrients

Strategically-timed exercise Strategically-timed exercise

What Is Intermittent What Is Intermittent Fasting?Fasting?

Intermittent fasting (IF) is a pattern of eating Intermittent fasting (IF) is a pattern of eating that alternates between pre-determined and that alternates between pre-determined and strategically-timed periods of fasting and non-strategically-timed periods of fasting and non-fastingfasting

Alternative to continuous caloric restriction or Alternative to continuous caloric restriction or other diets based on nutrient compositionother diets based on nutrient composition

Focus is on Focus is on whenwhen to eat; not on to eat; not on what what to eatto eat

Timing of meals optimizes how our bodies were Timing of meals optimizes how our bodies were evolved to metabolize nutrientsevolved to metabolize nutrients

Benefits of Intermittent Benefits of Intermittent FastingFasting

ReducedReduced

Blood pressureBlood pressureBlood lipidsBlood lipids

Inflammation Inflammation

IncreasedIncreased

Fat burningFat burningGrowth Growth

HormoneHormoneMetabolic rateMetabolic rate

ImprovedImproved

Appetite Appetite Blood sugarBlood sugar

NeurogenesisNeurogenesis

Variants of IFVariants of IF

Alternate day fasting (36 hour fast/12 hour Alternate day fasting (36 hour fast/12 hour feed)feed)

Meal-skipping (Random)Meal-skipping (Random)

Eat Stop Eat (24 hour fast, 1 or 2 times per Eat Stop Eat (24 hour fast, 1 or 2 times per week)week)

Leangains (16 hour fast/8 hour feed)Leangains (16 hour fast/8 hour feed)

Warrior Diet (20 hour fast/4 hour feed)Warrior Diet (20 hour fast/4 hour feed)

Example of IF ProtocolExample of IF Protocol

Induction Phase: 2 weeksInduction Phase: 2 weeks

Limit meals to one 8-hour window (Noon-8:00 Limit meals to one 8-hour window (Noon-8:00 pm)pm)

Maintenance Phase Maintenance Phase

Limit meals to one 4-hour window (6:00 pm-Limit meals to one 4-hour window (6:00 pm-10:00 pm)10:00 pm)

During fasting, may consume coffee, green tea, During fasting, may consume coffee, green tea, fiber, or branched-chain amino acidsfiber, or branched-chain amino acids

What to eat during a What to eat during a feeding windowfeeding window

De Souza, “Alternatives For Macronutirent Intake and Chronic Disease ”, De Souza, “Alternatives For Macronutirent Intake and Chronic Disease ”, The American Journal of Clinical The American Journal of Clinical NutritionNutrition, July 2008. , July 2008.

Generally, diets with a Generally, diets with a higher percentage of higher percentage of

macronutrients coming macronutrients coming from protein and fat are from protein and fat are

preferred during periods of preferred during periods of caloric restrictioncaloric restriction

Key Nutrients for IF Key Nutrients for IF

Fiber: 3-5 grams twice dailyFiber: 3-5 grams twice daily

Healthy fatsHealthy fats

Omega-3 fatty acids: 2 grams twice dailyOmega-3 fatty acids: 2 grams twice daily

Medium-chain triglycerides: 15 grams twice Medium-chain triglycerides: 15 grams twice dailydaily

Branched-chain amino acids: 10-15 grams Branched-chain amino acids: 10-15 grams twice dailytwice daily

Healthy Fats Healthy Fats Omega-3 Fatty Acids (Fish Oil): 2 grams twice Omega-3 Fatty Acids (Fish Oil): 2 grams twice dailydaily

Medium-Chain Triglycerides (Coconut Oil): 15 Medium-Chain Triglycerides (Coconut Oil): 15 grams twice daily; preferably at beginning and grams twice daily; preferably at beginning and end of fastend of fast

Healthy fats will accentuate benefits of IF by:Healthy fats will accentuate benefits of IF by:

Inducing production of ketones, used as Inducing production of ketones, used as alternative energy source by brain and musclealternative energy source by brain and muscle

Reducing hungerReducing hunger

Improving mood and cognitionImproving mood and cognition

Branched-Chain Amino Branched-Chain Amino AcidsAcids

Essential amino acids leucine, isoleucine and Essential amino acids leucine, isoleucine and valinevaline

BCAAs maintain muscle mass while dieting BCAAs maintain muscle mass while dieting

BCAAs reduce hunger and balance blood sugarBCAAs reduce hunger and balance blood sugar

Precursors to gluconeogenic glutamine and Precursors to gluconeogenic glutamine and alaninealanine

BCAAs “may cause weight loss through signalling BCAAs “may cause weight loss through signalling mechanisms to brain and adipose tissue” mechanisms to brain and adipose tissue”

Exercise and Weight Exercise and Weight Loss Loss

In long-run exercise alone is not effective for long-term In long-run exercise alone is not effective for long-term weight managementweight management

Increases compensatory eating and reduction in Increases compensatory eating and reduction in daytime activitydaytime activity

Increases stress hormone cortisolIncreases stress hormone cortisol

Likely to lead to repetitive-use injuries Likely to lead to repetitive-use injuries

Exercise during induction phase of IF:Exercise during induction phase of IF:

Leisurely walks of 30-60 minutes/dayLeisurely walks of 30-60 minutes/day

Exercise during maintenance phase of IF:Exercise during maintenance phase of IF:

Daily walks AND resistance-training 2-3 times per weekDaily walks AND resistance-training 2-3 times per week

Role of Resistance-Role of Resistance-TrainingTraining

Preserves muscle mass during periods of Preserves muscle mass during periods of caloric restrictioncaloric restriction

Improvements in lean body mass associated Improvements in lean body mass associated with improved blood glucose with improved blood glucose

Increases Growth Hormone induced by IF Increases Growth Hormone induced by IF

Effects of Resistance-Training v. Effects of Resistance-Training v. Aerobic Training on LBMAerobic Training on LBM

LBM is preserved and RMR is LBM is preserved and RMR is increasedincreased when diet is when diet is

combinedcombined with with resistance-trainingresistance-training

LBM is LBM is lostlost and RMR is and RMR is decreaseddecreased when diet is when diet is

combinedcombined with with aerobic-trainingaerobic-training

Bryner, “Effects of Resistance vs. Aerobic Training Combined with an 800 Calorie Liquid Diet on Lean Bryner, “Effects of Resistance vs. Aerobic Training Combined with an 800 Calorie Liquid Diet on Lean Body Mass and Resting Metabolic Rate”, Body Mass and Resting Metabolic Rate”, Journal of The Americal College of NutritionJournal of The Americal College of Nutrition, 1999. , 1999.

Strategically-Timed Strategically-Timed ExerciseExercise

Exercising in such a way as to optimize Exercising in such a way as to optimize hormonal and anti-inflammatory effects of hormonal and anti-inflammatory effects of intermittent fastingintermittent fasting

Leisurely walks done during fasting periods to Leisurely walks done during fasting periods to reduce cortisolreduce cortisol

Resistance training done toward the end of the Resistance training done toward the end of the fasting periods to increase growth hormone fasting periods to increase growth hormone and increase glucose sensitivity of muscle and increase glucose sensitivity of muscle tissuetissue

Summary Summary

Intermittent fasting associated with multiple health Intermittent fasting associated with multiple health benefitsbenefits

Blood glucose, growth hormone, fatty acid Blood glucose, growth hormone, fatty acid oxidation oxidation

Health benefits are optimized when intermittent Health benefits are optimized when intermittent fasting combined with:fasting combined with:

Key nutrients (fiber, healthy fats, BCAAs)Key nutrients (fiber, healthy fats, BCAAs)

Strategically-timed exercise (leisurely walks and/or Strategically-timed exercise (leisurely walks and/or resistance training)resistance training)

When diet is wrong When diet is wrong medicine is of no use; medicine is of no use;

When diet is correct When diet is correct medicine is of no medicine is of no need.need.

~Ayurvedic Proverb~Ayurvedic Proverb

Next StepsNext Steps

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