Healthy Body

Timing is everything

Intermittent fasting is not a panacea but may work for you.

People are not machines. We are complex and each of us unique in many ways. Even so, there are certain things about us that are pretty much the same across the board regardless of age, sex, intelligence and other attributes. 

One of these areas of common ground is this: we are not plants. We cannot manufacture food and nourishment out of thin air. To live, we must eat. If we eat more calories than we burn, our bodies will store the excess as fat. If we eat less, we lose weight. It really is that simple. You just don’t see fat people in places where starvation is endemic. 

Where the issues of complexity and uniqueness come into play is in our individual response to our diet. Some people can eat as much as they wish and stay thin. Others seem to eat relatively little and pile on the pounds. This makes establishing just how much food we should eat, how often and what kinds of things we should eat a difficult thing to do for a specific individual. 

Fasting goes back to time immemorial. Primitive man fasted involuntarily simply because food wasn’t always readily available. Some cultures have used fasting as part of rituals, such as religious practices. Today, fasting often is promoted as a magic bullet for weight loss. The catch, of course, is that you can’t fast forever. Once you get to your goal weight, if, indeed, you get there, you have to resume eating, and if you are typical, the weight will come back quickly. There are many physiological explanations for why fasting doesn’t seem to work. One is that, in starvation, our body becomes very efficient in using and storing food calories as fat, so when eating is resumed, we store more fat relative to those who don’t fast. 

As we have learned more about fasting and how it affects us, the importance of timing has become more and more recognized. All people function based on a natural cycle, called our circadian rhythm. Typically, we are active during the day and sleep at night. The cycle is important in that people whose normal cycle is disrupted—for example, their awake/sleep pattern is erratic or reversed—are more subject to various ills. Our ability to digest food and tendency to store fat varies throughout the day. Based on this information, the program known as intermittent fasting has come to the fore as the newest iteration in the hunt for an effective way to lose weight and, equally important, keep the excess weight off over the long term. 

Intermittent fasting involves timed eating. It may be fasting every other day. Usually, it is done on a daily cycle, with an eating period of between eight and 12 hours a day. Schedules include eating only from 7am-3pm, 7am-7pm or 10am-6pm, all of which extend the period of fasting overnight. You use the schedule that works for you and—this is critical—that you can sustain. 

There is good data behind the concept of fasting intermittently. The simplest explanation of intermittent fasting is that you restrict eating to a specific, limited period of the day. In between, you can drink noncaloric fluids, including tea and coffee. Alcohol should be avoided or very restricted. During the eating period, you do not have to count calories or only eat particular foods. Intermittent fasting exemplifies something that I have always believed about eating: it should be simple. You should not need a degree in medicine or nutrition in order to feed yourself in a healthy manner. 

There are several conditions that should be met if intermittent fasting is to be effective, healthy and sustainable. You must eat clean and healthily. Don’t gorge yourself. Avoid refined, added sugar; eat healthy fats; eat high quality protein; avoid salty, sugary, fried fat foods. A diet along the lines of the Mediterranean diet is probably as good as any: lots of fresh fruits and vegetables, nuts and legumes, fish and limited animal protein. Avoid snacking. Drink enough fluids so that your urine is not dark. It really isn’t rocket science. 

Intermittent fasting can even benefit people who are not overweight or obese. Intermittent fasting has been shown to provide benefits in lowering high blood pressure, lowering cholesterol levels and improving blood-sugar control in diabetics. 

One important caveat is that anytime you begin any diet, especially one that involves extended periods of fasting, you should inform your physician. This is especially important for people with diabetes, where fasting may necessitate an adjustment to medication doses. 

Intermittent fasting is not a panacea. It should go without saying that diet is only one factor in controlling weight and being healthy. You should be as physically active as possible, get enough rest and control stress in your life. 


About the author

Rick Bosshardt, M.D., FACS

Richard Bosshardt, M.D., graduated from the University of Miami School of Medicine in 1978. He founded Bosshardt & Marzek Plastic Surgery Associates, Lake County’s first practice to provide full-time cosmetic and reconstructive plastic surgery services, in 1989.

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