FASTING

FREQUENTLY ASKED QUESTIONS

DOES INTERMITTENT FASTING WORK WITHOUT CUTTING CARBS TOTALLY?

Yes!  This question brings me to a bit of a tangent, but when someone says “low carb,” you do not have to eliminate all carbohydrates completely. Current dietary guidelines state that 45%-65% of daily caloric intake should come from carbohydrates (1). However, it is essential to recognize these recommendations were not based on evidence. If we want to get “technical,” your body doesn’t NEED carbohydrates. The liver can synthesize all the glucose you need (assuming your metabolic system is intact) to maintain functioning.  

Therefore, having a dietary recommendation in which a “required” amount of a macronutrient, which is not essential for survival, does not make sense. Now note, I did not say carbohydrates, in general, did not have health benefits (2), but the processed carbohydrates, which line shelves, pantries, and have an ingredients list out of organic chemistry should be minimized and outright avoided. Carbohydrates should include NATURAL ones, mainly plants. Avoid sugars made in a laboratory.

In fact, the ADA just released updated guidelines to include carbohydrate restriction of less than 26% of total daily intake or roughly 130 gm a day in the treatment of Type 2 diabetes (3). I think this is a good target to shoot for with intermittent fasting. As the average person consumes too many processed foods.  

So, no, you do not have to eliminate carbs with intermittent fasting to lose weight, but reducing processed carbohydrates will serve you far beyond the scale.

HOW DO I GET BACK ON THE CARB-FREE TRAIN IF I SLIP UP?

My first point to this answer is you do not have to be “carb-free” (see my answer above). The question requires more detail. Are we referring to junk or “fake” healthy foods for that matter? Ones from a package? To my knowledge, no one ever developed diabetes from overeating broccoli, which is also considered carbs. 

Now if we are referring to high sugar, high starch, lots of bread, pasta, etc. I tend to do the following:

  1. Acknowledge what I ate and affirm this was the exception to the rule.
  2. Don’t beat yourself up. Again, we all have various slip-ups or times of celebration where we may veer off plan. As long as this isn’t a weekly occurrence, you are unlikely to have derailed your goals.
  3. For me, starting back up on a tight fasting schedule works. This consists mainly of water, but I will use coffee, tea, or bone broth, if needed. Lately, I’ve preferred coffee, tea, and water as opposed to bone broth. I still consume bone broth, but usually during my eating window, not during my fasting window.
  4. Tightening up my fasting window:
    1. If I usually were to complete a 12pm-7pm, I may tighten it up and do 11am and 4pm without snacking in-between for a few days. 
    2. I also decrease my carb intake to reach a lower overall value. I aim for 75 gm or less of carbs daily when getting back on the wagon and gradually return to 100 gm or less daily, which works well for me, given my activity and fasting level.

DO YOU FAST DAILY?

Pretty much!  I would say I do not fast 3-5 times a month.  During these times, I still avoid snacking and eat only at meals (for the most part).

HOW LONG DOES IT TAKE TO ADJUST?

Everyone is different, however, if you are also reducing processed carbs at the same time, your body may experience “the keto flu” as your body decreases its reliance on glucose as its primary energy source.  For instance, I had a terrible (exaggerating a bit) headache after spending 6 days at my parents’ house over the holidays. I started off well, but I had way too many carbs, threw myself entirely out of ketosis, filled my liver back up with glycogen, and then had to convert back to burning fat.   

The headache and temporary grumpiness usually last a day or two. Some people say it’s taken them up to a week to transition. Also, many find hydration is the key during the initial transition period. Remember to keep up on water and electrolytes!

If you are new to intermittent fasting, starting off slowly and then gradually building up your time between meals is a great place to start and give yourself time to adapt.

I’VE STARTED INTERMITTENT FASTING AND ONLY EAT FROM 11AM TO 3 OR 4PM. IS THIS OK?

Assuming medical conditions are not present, you are maximizing your circadian rhythm. Once dark, we tend to have a more significant insulin response than we would have if consumed during light. Make sure meals during your eating window are nutritious and satisfying!

HOW DO YOU DEAL WITH EMOTIONAL EATING?

This is something I still trip up on from time to time.

For me, I think it is crucial to identify your root cause of stress and then find other measures to tackle or relieve stress and anxiety.

My friend introduced me to the insight timer, which is a free app with meditation. You can begin with short meditations of 1 minute daily. Once you find a mediation that speaks to you, you can try doing this first in times of emotional triggers for eating.  Fix a nice cup of warm tea and meditate.

HOW DO I HASTEN WEIGHT-LOSS USING INTERMITTENT FASTING? IT SEEMS I HAVE STALLED.

This is not uncommon, particularly if you were following one meal a day, or the same 16:8 schedule for a prolonged period of time. Our bodies are intelligent. We are designed to adapt. Dr. Jason Fung, the author of the Obesity Code, discusses almost an eventual chronic caloric restriction at one meal a day. It is hard to consume enough calories in one sitting to prevent your body from believing there is food scarcity.  

Changing up your fasting regimen can help get the scales moving again. For example, if one has an eating window of 12pm-8pm, maybe 2-3 times a week, adjust that window from 10am-4pm. Some people opt to add in a 36 hour fast a couple times a month (assuming you have discussed this with your health care provider and do not have medical contraindications to do so).  Many people have seen great success without ever doing a fast longer than 24 hours, so a longer fast is certainly not needed. Start with changing your window and make sure you are not consuming sweeteners during your fasting window.

The other thing question pertains to nutrition? Fasting isn’t a free for all that allows you to eat lots of processed foods between fasts. If you haven’t tracked your macros before, consider downloading MyFitnessPal and get a gauge as to how many carbohydrates you consume daily and downward adjust, particularly if over 130-150 gm total.

DO YOU MEAL PLAN?

Sort of. I cook in bulk a couple of times a week. I usually work through or exercise at lunch a few days a week, which cuts down on the amount of planning needed. Aldi is my BEST friend. I usually stop by once a week or once every two weeks and stock up on tomatoes, cucumbers, and other fresh produce. I keep these in the fridge at work, which helps complete my meal. I prepare a protein source at home, which can be anything from shrimp, chicken, beef, fish, or jerk tofu. This helps me prep less while also increasing plant intake.

WHAT CAN BEST REPLACE WHITE BREAD ON A DAY-TO-DAY ROUTINE?

I would say with nothing! I would gradually phase it out of your diet until you can go weeks to months without eating bread. If I’m eating a hamburger or tacos, I substitute the bread or tortillas for lettuce and make it a wrap. Very tasty! 

Since I consume bread less than once a month, if there is an occasion where we are out to eat, I don’t worry about it because this is a rare occasion for me.

HOW MANY HOURS IS YOUR EATING WINDOW?

Typically around 6 hours.  This can vary depending on the occasion.

WHERE DO I START? WHAT ARE SOME GOOD RESOURCES TO BEGIN?

My blog, newsletter, Instagram, and Facebook group! ?

Resources: The Obesity Code, by Dr. Jason Fung. Just read it! Don’t wait for someone to give you a summary. You are making a life long investment in your health, and there are no short cuts.  Alternatively, Google him and watch his YouTube videos.

I would read Dr. Fung’s book first and then dive into more about low carb and ancestral based diets. The Diet Doctor website (https://dietdoctor.com) is excellent with many free resources regarding low carb.  Also, the Intensive Dietary Management Program (https://idmprogram.com) has a free 12-week fasting course.

While you are learning more, reading, watching YouTube, etc., here are a few tips to get you started:

The 142 lbs average sugar consumption by the US adult is FAR more than our bodies were designed to handle. Why not try the following, simple steps to decrease your sugar intake?

  • Cut out sugary drinks, even if it says Diet, agave nectar, Stevia, etc. Drink water!
  • Cut out packaged snacks. If the ingredient list has more than 3-4 items, and/or you need a masters in organic chemistry to understand what it is, time to put it up. Trying to minimize snacking altogether is best, but if you must snack select whole foods. 
  • Try increasing the number of proteins, healthy fats, and vegetables on your plate. Rather than filling up on bread, pasta, and packaged snacks prioritize your green leafy vegetables rather than more starches.
  • Try to have your last meal each day no later than 7pm and have your first meal in the morning no earlier than 9-10 am. This will slowly introduce you to intermittent fasting. You can gradually shrink your window 1-2 days a week and play around with various times. AVOID NIGHT EATING.  This throws off our circadian rhythm.

ARE THERE GROUPS OF PEOPLE WHO SHOULD AVOID INTERMITTENT FASTING?

In general, intermittent fasting is safe; however, you should proceed with caution, or avoid (unless cleared by your healthcare provider) if you have some of the following conditions:

  • Diabetics-particularly those on insulin
  • Lactating women
  • Pregnant women
  • Individuals with a history of eating disorders
  • Children under the age of 18
  • Individuals on antihypertensive agents due to the risk of low blood pressure

This list is not all-encompassing; therefore, you should consult your healthcare provider before any new dietary or exercise approach.


REFERENCES

  1. USDA. Dietary Guidelines For Americans 2015-2020 Eighth Edition. 2015.
  2. Serra-Majem L, Roman-Vinas B, Sanchez-Villegas A, Guasch-Ferre M, Corella D, La Vecchia C. Benefits of the Mediterranean diet: Epidemiological and molecular aspects. Mol Aspects Med. 2019.
  3. Davies MJ, D’Alessio DA, Fradkin J, Kernan WN, Mathieu C, Mingrone G, et al. Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes care. 2018;41(12):2669-701.

DISCLAIMER: The advice on this page is not meant to replace or represent medical advice. This is nutritional advice, which is NOT the same as medical advice. Before any weight loss endeavor, the consultation of an experienced health care provider is a must. As a general rule, the following individuals should not participate in fasting:

  • Diabetics-particularly those on insulin
  • Lactating women
  • Pregnant women
  • Individuals with a history of eating disorders
  • Children under the age of 18

This list is not all-encompassing; therefore, you should consult your healthcare provider before any new dietary or exercise approach.

Interaction through this blog’s associated social media accounts, podcasts, and other venues associated with The Fasting Doctor does not constitute a patient-physician relationship. Likewise, it does not constitute medical advice. By continuing to access this blog or related resources, you acknowledge and agree that the content and contributors are not liable for your personal use of dietary and wellness advice found in our contents. You acknowledge our recommendation to consult your care provider before utilizing our nutritional information.

For more information, please contact me at info@thefastingdoctor.com!

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