Semaglutide for Weight Loss

The Benefits of Intermittent Fasting

November 14, 2018 By , , , , , ,

Intermittent Fasting (Time-Restricted Eating)

I am so excited to share my passion for intermittent fasting with you. It has had a profound effect in my own life and I have seen it be a gateway for sustained weight loss after the HCG Diet program in hundreds of my patients.

Like anything new, it takes practice and time for it to feel natural. Similar to running a marathon, it takes some time to train.  Make a commitment to give it a try for 4 weeks and see how you feel.  It might take the first 2 weeks for your body to adjust. Please read below to understand more about how this protocol works.

As modern-day human beings, we have the option to be over fed quite often … yet our bodies are designed to spend more time in the fasted state. As I dive into the incredible scientifically backed research on this topic, specifically the work of Dr. Jason Fung MD., I find myself amazed and this just makes sense!

Fed vs Fasted

Your body is designed to smoothly transition between two different and opposing states: FED and FASTED.

In the fed state, insulin is elevated. In the presence of insulin, your body is programmed to store excess calories as fat. Insulin will also stop your body from burning any fat stores as it has glucose from your last meal to use instead.

In the fasted state, insulin is low.  In the presence of low insulin, the body starts mobilizing stored fat and using it for energy (instead of glucose from a meal).

The practical importance of all this? You can only burn stored body fat while in the fasted state, and you can only store more body fat while in the fed state.

Insulin Resistance

Unfortunately, in modern day, we seem to be spending more and more time in the fed state. As a result, our bodies spend less time mobilizing and burning stored body fat for energy and instead continually process glucose and store what is not needed for energy as fat.

In takes our bodies 8-12 hours from the last meal to get out of the fed state. If we are chronically in the fed state this means that insulin is high all the time and the body avoids burning stored body fat and relies mostly on glucose for fuel. Over time, this chronic exposure to high insulin levels leads to ‘insulin resistance,” where the body secretes even more insulin in response to a meal.  Chronic insulin resistance is the root cause of ‘metabolic syndrome’ which includes obesity, abdominal fat storage, high triglycerides, low HDL or “good” cholesterol, and elevated glucose and an eventual type 2 diabetes diagnosis.

A person with insulin resistance is burning predominately glucose on the cellular level and they rarely ever get the opportunity to burn body fat. When these people run out of glucose from their last meal, instead of easily transitioning over to the fasted state to burn fat, they become hungry for more glucose (from carbohydrates) as their bodies and cells have a decreased capacity for mobilizing and burning fat for energy. The vicious cycle.

Let’s put it this way. Why would a highly obese person EVER be hungry? They have enough fat stores to last a very long time. The world record for fasting went to a 456 lb. man who fasted for 382 days, consuming only water and vitamins and losing 276 pounds with no negative side effects.

However, the average overweight person is used to being in the fed state, has very little practice in the fasted state, and is continually burning glucose rather than fat at the cellular level. They have insulin resistance, which is both caused by and also leads to chronically high insulin levels, which promotes fat storage and suppresses fat mobilization from the adipocytes (fat cells). They even have changes in the mitochondria, or tiny energy factories inside the cells. The mitochondria can burn either glucose (sugar) or fat for fuel, and over time they will prefer one over the other; “sugar burners” have increased the pathways in the mitochondria that burn glucose and decreased, or down-regulated, the underused pathway for burning fat. So, what happens to the overweight “sugar burner” who stops eating for a few hours? As they run out of glucose from their last meal, instead of seamlessly transitioning to the fasted state and mobilizing and burning stored body fat, they become HUNGRY for MORE GLUCOSE, from carbohydrates! They will spend most of the day trapped in a cycle of eating every few hours, spiking glucose, and then becoming hungry when blood sugar drops.

Fat Adaptation

Humans can become ‘fat-adapted’ and improve their ability to fuel themselves with stored body fat instead of glucose. However, this takes time and practice, and your body must do several things to slowly up-regulate (or increase) your fat-burning pathways. This includes improving insulin sensitivity to lower insulin and promote fat mobilization into free fatty acids from the adipocytes (fat cells) as well as upregulating the fat-burning pathways at the cellular level (in the mitochondria).

There are several ways to improve ‘fat adaptation’ or the ability to successfully burn stored body fat for energy, and these include the following:

  • Low carbohydrate diets. Eating a low carb, moderate protein and moderate fat diet improves the body’s ability to utilize fat for energy rather than glucose as there is less glucose available due to the lower cab diet.
  • Exercise. High-intensity exercise depletes glucose and glycogen rapidly, forcing the body to switch over and utilize more fat for fuel. Exercise also improves insulin sensitivity.
  • Caloric restriction (not starvation). Eating fewer calories also equals less glucose available for fuel, so the body is more frequently forced to rely on stored body fat for fuel. Eat a diet of whole, natural, unprocessed foods as much as possible. Avoid processed foods completely.
  • Intermittent fasting and spending more time in the fasted state gives the body more ‘practice’ at burning fat.

Metabolic Exercise

The purpose of this is to highlight INTERMITTENT FASTING as a strategy for exercising and strengthening the body’s ability to exist in the fasted state ~ burning fat instead of continually burning sugar or glucose from the fed state.

Like anything, this ability to be in a fasted, fat-burning state can be strengthened over time with practice.  However, it takes consistent practice and like anything in life … “if you do not use it you lose it.”

Spending time in the fasted state is actually a form of exercise—a METABOLIC WORKOUT.

In fact, there are a lot of parallels between exercise and fasting.

Exercise does all the following great things:

 

  • Decreases blood glucose
  • Decreases insulin levels
  • Increases insulin sensitivity
  • Increases lipolysis and free fatty acid mobilization
  • Increases cellular fat oxidation
  • Increases glucagon (the opposite of insulin)
  • Increases growth hormone (the opposite of insulin)

 

 

HOWEVER, did you know you can also accomplish all the above by FASTING? Extending your time in the fasted state is a form of metabolic ‘exercise,’ in which you train your body to rapidly and efficiently mobilize free fatty acids from your fat stores.  This is something you absolutely can get better and better at with the metabolic ‘practice’ of fasting. Just as overweight and out of shape people may struggle to jog, lift weights or participate in other forms of physical exercise, they are also generally out of practice when it comes to rapidly and efficiently mobilizing and burning stored free fatty acids for fuel. Intermittent fasting and spending more of your day in the ‘fasted’ state (and less time in the ‘fed’ state) is a great form of metabolic ‘exercise’ which has many health benefits, including fat loss!

Less Feeding, More Fasting

One of the best ways to achieve effortless and long-lasting fat loss? Train yourself to eat two meals a day and decrease snacking.  Most intermittent fasting experts suggest the fast begin in the evening and go for 16 hours or more into the next morning.  The easiest way to accomplish this? Leverage your natural overnight fast by skipping breakfast.  You are welcome to have black coffee, green tea or water until your fasting window is over.  For me, I begin my fast at 7 pm and end my fast at 11 am the next day.

Typically, the fed state starts when you begin eating and for the next three to five hours your body digests and absorbs the food you just ate. In the fed state, insulin rises significantly, completely shutting off fat-burning and triggering excess calories to be stored as fat. After the first few hours mentioned above, your body goes into what is known as the post–absorptive state, during which the components of the last meal are still in the circulation. The post–absorptive state lasts until 8 to 12 hours after your last meal, which is when you enter the fasted state. It typically takes 12 hours after your last meal to fully enter the fasted state.

In the fed state, we also recommend avoiding high glycemic carbohydrates if you can. Eating carbohydrates, especially refined carbohydrates, overdrives the ‘fed’ state.  Carbohydrates raise both glucose and insulin higher than other macronutrients while fat, raises glucose and insulin the very least.

When you’re in the fasted state your body can burn fat that was inaccessible during the fed state. Because we don’t enter the fasted state until 12 hours after our last meal, it’s rare in modern day that our bodies are in this fat burning state. This is one of the reasons why most people who begin intermittent fasting will lose fat without changing what they eat, how much they eat, or how often they exercise. Fasting puts your body in a fat burning state that you rarely get to enter during a normal eating schedule.

Fasting Myths

There are many myths about fasting:

“Breakfast is the most important meal of the day!”

We have all been told to eat breakfast. Unfortunately, this is not sound advice. When you first wake up in the morning, your insulin level is quite low, and most people are just starting to enter the fasted state. Remember, it takes 12 hours after eating your last meal to get to a fasting state.

It is not the best idea to consume food which will raise glucose and insulin and take you out of the fasted state and fat burning mode.   The worst idea would be to eat a high carbohydrate breakfast, spiking insulin and glucose as high as possible. In addition to shutting off fat-burning for up to 12 hours, this will drive as many calories as possible into fat stores as well as providing further reinforcement of the burning of glucose rather than fat. Also, high spikes of insulin and glucose always lead to large drops in glucose a few hours later, which triggers HUNGER (if you want to have hypoglycemia or low blood sugar and ravenous hunger, just eat a breakfast of pure carbohydrates and then wait 2-3 hours to see how you feel).

A better choice would be to push the first meal of your day out at least a few hours, during which you can fully enter the fasted state and burn stored body fat. The truth is that many fat-adapted people aren’t very hungry in the morning and have no problem skipping breakfast. This is appropriate, as throughout our evolution humans have always been hunter-gatherers and rather than eating a large breakfast first thing in the morning we would hunt and gather throughout the day, having a larger meal later in the afternoon. I highly recommend mimicking this pattern by skipping breakfast and eating most of your calories later in the day.

 “Eat small frequent meals.”

In the opinion of many health professionals, this is not great advice.  We have been told to eat frequently to “keep your metabolism going” and “don’t let your body enter starvation mode.”

This is all the exact opposite of the truth according to the science that I have been reading and the clinical experience I have had with my patients: in order to burn fat, you want to spend as much time in the fasted state as possible and get efficient at living on stored body fat rather than caloric intake from constantly eating food.  Similarly, we have been told to eat protein frequently throughout the day to build muscle and stay satiated.  Our body is constantly recycling protein and we do not need nearly as much as many say that we do. Of course, we need some high-quality proteins, but we do not need to overdo it.

“Fasting leads to burning muscle instead of fat.”

Many people are concerned that if they start fasting they will burn muscle. This is not true. If this were true, humans would not be here today. In fact, growth hormone is increased during fasted states. Growth hormone might as well be called the “fasting hormone,” as it rises by as much as 2,000% after 24 hours of fasting. Growth hormone is highly anabolic (builds muscle) and is used in combination with testosterone by bodybuilders who want to simultaneously build as much muscle and burn as much fat as possible. Growth hormone elevates in fasting to help preserve muscle in times of fasting. In our hunter-gatherer ancestors, if fasting created weakness in the body it would have been a challenge to stay alive.

In fact, the opposite is true … while fasting; muscle is preserved and can even increase if you are doing resistance training (highly recommended). Also, people experience an increased level of focus and alertness during fasting thanks to the release of epinephrine and norepinephrine (earlier in our evolution this increased energy and alertness helped us catch prey when necessary). I can tell you that since I have been intermittent fasting my level of mental clarity and focus is better than it has ever been, and I exercise with high intensity in the fasted state without losing energy.

 “Your metabolism slows down when you are fasting.”

This is false. Several studies have proven that in fasting up to 72 hours, metabolism does not slow down … in fact; some studies show that it can speed up slightly thanks to the release of catecholamines (epinephrine or adrenaline, nor-epinephrine, and dopamine) and the activation of the sympathetic nervous system.  It makes sense that this fight or flight sympathetic nervous system would be activated during the daytime, when hunter-gatherer humans are most active and in the fasted state (looking for food), followed by parasympathetic “rest and digest” mode in the evening after eating a large meal.

“If I don’t eat I will get low blood sugar [hypoglycemia].”

Studies have shown that healthy persons who have no underlying medical conditions, who are not taking any diabetes medications, can fast for extremely long periods of time without suffering from hypoglycemia. In fact, almost all sensations of hypoglycemia or low blood sugar (in non-diabetics) results from eating a diet high in refined carbohydrate food a few hours prior.  What happens in these cases is … blood sugar spikes, then insulin spikes and then blood sugar drops rapidly. However, if you are a diabetic, especially if you are on any diabetes medications, you need to check with your doctor before starting a fasting protocol. Some diabetes medications can lead to severe hypoglycemia when fasting (mostly insulin and sulfonylurea drugs like glipizide, glimepiride, and glyburide). ALWAYS be sure to check with your doctor prior to starting a fasting protocol if you have any medical problems, diabetes or otherwise.

How to Fast Intermittently

There are several ways to perform intermittent fasting, but the easiest and most popular varieties involve taking advantage of your natural overnight fast by skipping breakfast and pushing the first meal of the day forward a number of hours. Once you have passed the 12-hour mark from dinner the night before, you are truly in a fasted state and you begin to rely on stored body fat for fuel. The longer you stay in the fasted state, the more metabolic practice you will get at burning stored body fat and the deeper your fat adaptation will get. In fact, if you can maintain this intermittent fast for 20 to 24 hours you will achieve a very high rate of lipolysis (breakdown of stored body fat into free fatty acids, available for burning in the cells) and fat oxidation (burning of fat in the mitochondria). When you first start out with intermittent fasting, you can have quite a bit of hunger and low energy and other detox symptoms. In this case I recommend starting out with “baby steps,” by simply pushing breakfast out an hour at first, then slowly increasing the fasting interval. As time goes by and you become more “fat adapted,” it is easier and easier to fast. This is identical to exercise in those who are sedentary: it is painful and extremely difficult at first, and then once you are adapted it gets easy and even enjoyable.

 LCHF (Lower Carb/Higher Fat) Diet for Fat Adaptation

It is much easier to fast if you are already on a LCHF diet, as these diets naturally lead to quite a bit of fat adaptation and are naturally lower in the secretion of insulin as well as the utilization of glucose as a fuel. In fact, I HIGHLY recommend the combination of a low carb diet with intermittent fasting. The closer you get to a diet low in carbohydrates, moderate in protein, and moderate in fat the easier it is to go for hours and hours without eating, thanks to the fat adaptation that these diets create.

For those who do incorporate carbohydrates in the diet, I would recommend that these mostly consist of FIBER, which is indigestible and does not contribute to the elevation of glucose and insulin.  It is ideal to put digestible (non-fiber) carbohydrates in the evening, and ideally only after either fasting for a long period (to deplete liver glycogen) or exercising with a high level of intensity to deplete muscle glycogen.  Eating carbohydrates when your muscle and liver glycogen are already full is guaranteed to lead to fat storage and worsening insulin sensitivity … this is the exact opposite of what we are looking for.

Popular Forms of Intermittent Fasting

There are several popular ways to accomplish intermittent fasting and I will discuss the method here that I feel is a great place to start.  Once you get used to the method of fasting for 16 hours and eating for 8 hours in a 24-hour period you can challenge yourself to doing longer fasting periods.

Keep in mind that it takes 12 hours to get into the fasting state and the eating window for the average American is greater than 12 hours/day and therefore they never reach this prime fat burning zone.

Lean gains Method ~ 8 hours Feasting and 16 hours Fasting (8:16)

This is just one method of intermittent fasting and clearly the most popular. I feel this is a great place to start!

Lean gains, as popularized by bodybuilder Martin Berkhan, is by far the most popular method of fasting intermittently. This form of fasting consists of skipping breakfast every morning and pushing the first meal of the day to lunch. Basically, you skip breakfast and then eat a normal lunch and dinner in an eight-hour window.  The idea is to fast for 16 hours (using the overnight sleep period) and then eat all your calories in an 8-hour window.  For example, let’s say you get up at 6:00 a.m.; you would skip breakfast and eat nothing for six hours, then begin eating at noon and end eating at 8 pm.  This 16:8 split (16 hours fasting and 8 hours eating) is recommended every single day.  You could also choose 10-6, 11-7 and so on. You can create your 8-hour eating window wherever you like.  From there, you can alter it.  Personally, I eat from 10:30 am to 5:30 pm and then fast for 17 hours. My goal is to get to a 6-hour eating window and then have an 18-hour fasted state. This will happen in time!

Find an eating window that feels best for you and shoot for 8 hours of eating and 16 hours of fasting each day to begin.

Non-Caloric Beverages in the Fasting State

During the fasting window feel free to drink ANY non-caloric beverage you want, including but not limited to: water, coffee (with or without non-caloric sweetener such as stevia), tea (hot or iced, sweetened with stevia if desired), Zevia, sparkling water, etc.  However, I would NOT recommend any calories AT ALL, as it takes very few calories to increase insulin and take you out of the fasting state. Fat is the macronutrient that spikes insulin the very least, which is why so many people are using bulletproof coffee or some other method of adding fat to coffee in the morning.  However, I would NOT recommend this or any other source of calories while fasting, as this will be work against what you are trying to accomplish with fasting.

If you absolutely cannot live without a tiny splash of cream in your coffee … then do it!   You will be better off doing that and trying intermittent fasting than letting the whole idea go.  However, I would try to keep the cream in your coffee to an absolute MINIMUM quantity, and you should also use this opportunity to learn to drink coffee black (this is something anyone can learn over time, believe it or not). I recommend the use of black coffee or tea in the morning to make your fast easier and more enjoyable. Both coffee and tea have numerous health benefits, and they both contain compounds that help with fat burning, energy, and alertness.

Enjoy Your Freedom from Food

Once you are properly fat adapted, intermittent fasting is easy, fun, enjoyable, and liberating—while making you leaner and healthier in the process! Let’s say you are following the 16/8 protocol. Breakfast every day during the work week is now JUST BLACK COFFEE, how easy is that? No more worrying about what you are going to grab for breakfast as you rush around in the morning and struggle to get to work on time. This saves a lot of time and is literally a form of metabolic exercise in the meantime, improving your insulin sensitivity and strengthening your fat adaptation. This is a win in many ways. It also frees you to eat very large and satisfying meals later in the day, without feeling the deprivation of watching calories.  It is amazing not to worry about food as much and center your life around it.

Some Pointers …  

  • Check with your doctor before initiating intermittent fasting, ESPECIALLY if you are diabetic and on diabetes medications! This is not for children, pregnant or breast-feeding women and people with various health conditions.
  • Minimize calories naturally by choosing only nutrient rich foods. Eat real, whole foods found in nature. Avoid processed foods such as grains, sugars, starches and industrial oils such as vegetable oil, soybean oil, canola oil and corn oil.
  • You can generally take any vitamins or supplements you want while fasting as long as they don’t have calories. Although, you can also take supplement “vacations” as you will be eating plenty of nutrient-dense foods every day.
  • You don’t have to worry about losing muscle from lack of protein during your fast. Eat adequate protein at the meals before and after fasting. I exercise with great intensity most days and find 30-40 grams of protein is all that I need.
  • Give your body time to adjust! You might not really be hungry; you’ve just trained your body to expect food every 2 hours over many years. This could take a week or more to get used to. Treat this like a 1-month experiment. See how your body responds and adjust along the way.
  • Consume enough calories for your body type and goals. During your feasting window, eat healthy sized meals that leave you comfortably full. Track your progress. Gaining weight? Reduce calories by 10%. Losing too much weight? Increase calories by 10%. Test, compare, learn, change, fix, and test!
  • Following a LCHF (lower carb/higher fat) diet pairs nicely with intermittent fasting, as both improve fat adaptation a great deal.
  • Drink plenty of water and non-caloric beverages while fasting; coffee and tea in the morning make fasting considerably more enjoyable in addition to health and fat-burning benefits and are therefore highly recommended. No liquid calories please.
  • Don’t use intermittent fasting as an excuse to eat tons of junk food when you are eating—continue to eat responsibly, sticking with whole natural foods with high nutrient density and avoid processed foods.
  • It is perfectly fine to exercise while fasting, either cardio or lifting weights (lifting weights is better for body composition and I highly recommend it for everyone, as this will further your goals considerably). High intensity impact training for 15-30 minutes is a great way to boost fat burning in the fasted state.
  • This is not for children, pregnant woman, breast feeding women or insulin dependent diabetics. Please check with a health professional to be sure this is a proper plan for you.

 

 

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