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Intermittent fasting works – not only for weight loss but also for heart health

washingtonpost.com

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Re: Intermittent fasting works – not only for weight loss but also for heart health

#101
post #10

> How do you start? Agatston told me to start by skipping one meal a day, usually breakfast. (Yes, you can have black coffee in the morning, into which he adds ghee, a type of clarified butter, and coconut oil to reduce hunger pangs. It’s not your typical cup of coffee.) This may be ok to start with, though black coffee by itself has the ability to kill hunger without these crutches. Adding ghee or coconut oil in bla…

> Adding ghee or coconut oil in black coffee means it’s no longer effectively zero calories, and this is not technically fasting. I guess it depends on how you choose to define your "technical" terms. For example ( https://www.bulletproof.com/diet/bulletproof-diet/bulletproo... ): "The technical definition of “fasting” describes not consuming a single calorie. When your body isn’t burdened with the task of digestion…

> it has a chance to carry out cleaning and repair processes that make you healthier

Sounds like Goop-grade quack science to me. :-)

Re: Intermittent fasting works – not only for weight loss but also for heart health

#102

Earlier quoted context omitted.

If your black coffee tastes disgusting on its own, you need to buy better coffee.

It’s addictive, so your taste will adapt to what you regularly have. It’s entirely possible to train your body to love instant, you just need to stick with it.

"I only eat dollar store steak and your body needs calories so your taste will adapt."

You can say this about literally any food. Nonsense.

Re: Intermittent fasting works – not only for weight loss but also for heart health

#103
post #50

Earlier quoted context omitted.

And use good water, and follow best practices for whatever brewing method you prefer. Failing any of these (including getting quality beans that are recently brewed), and your coffee may be much worse than it needs to be. I despise Nestle business and social practices, but a Nespresso machine with Nespresso pods is probably the best coffee that most people could hope to make.

Roasted *, but I disagree. Nespresso is easy, but it's expensive and even at best it tastes like hot garbage. You can grab aeropress for like 30 dollars and throw in a metal filter for like 5 dollars and that's already capable of making single cups of excellent coffee for years. My current aeropress and filter are from 2012 and I'm not really in need of an upgrade any time soon so it's honestly a very affordable brew…

As someone who has just started the journey towards coffee snobbery, I quickly had the impression that the grinder is the most important piece of kit needed, but from my research the electric burr grinders My point is that this effort is not feasible for most people. If my morning drink takes me more effort than getting showered and dressed, i'll probably forgo it 90% of the time. I'm working on this form of laziness, but that's the willpower/patience most people have to live with. In addition there is a whole host of other reasons why something that's easy and routine for you can be quite vexing for other people.

Opening a can takes less then ten seconds, we're already talking about a harsh diet change, we don't have to make it harder than necessary for people.

Re: Intermittent fasting works – not only for weight loss but also for heart health

#104
post #9

Earlier quoted context omitted.

> The quirk on this one is that occasionally you skip breakfast, too. I've done intermittent fasting (IF) for the past 5 years. Apart from a black espresso every morning, I skip breakfast all the time (not just occasionally). Skipping breakfast is a psychological trick (that doesn't work on everybody, but works well enough to make a difference). The real goal is to entice oneself to eat less by eating fewer meals in…

> Skipping breakfast is a psychological trick Perhaps, but for some people it's also a physiological risk. I eat about 1200 calories for breakfast as my body otherwise cannot function for the day. Whether fasting is appropriate depends on one's body composition, daily exertion routine and physiological factors. For most people I'd recommend exercise instead of fasting.

> For most people I'd recommend exercise instead of fasting.

A lot of what I've read over the past few years suggests that exercise won't help you lose weight[0]. It's great for general health, but exercise without some kind of diet modification generally won't do all that much for your weight.

This tracks with my experience, at least. In early 2016 my doc told me I needed to get some exercise. At the time I was doing nothing more than walking to and from work (60 mins total). I started running, and worked up to around 10 miles per week. I'd already been more or less been doing IF for a while (without realizing it; I was just never hungry when I woke up), eating lunch at noon and dinner at 7pm, or just a single mid-afternoon meal around 3pm.

I didn't start actually losing weight until 2 years later, when I started calorie counting and attempting to limit my intake to around 1500 per day (I wasn't always successful). It was still difficult; I only lost 6 or 7 lbs, and it took nearly a year to do that.

That turned out to be hard to maintain; I stopped counting calories, and by late 2019 I'd put those lbs back on and probably a couple more, even with IF in place.

With COVID-19, I've been cooking 6 days a week, so that's meant less oil/butter, nothing fried, but still a good amount of carbs. My running has dropped to 4-6 miles a week. But in less than three months, I've lost 15 lbs. The only thing that actually worked was changing my diet. Once things go back to normal and I'm going out to restaurants again, I fully expect I'll put that weight back on.

[0] E.g. https://www.vox.com/2016/4/28/11518804/weight-loss-exercise-...

Re: Intermittent fasting works – not only for weight loss but also for heart health

#105

Earlier quoted context omitted.

It’s addictive, so your taste will adapt to what you regularly have. It’s entirely possible to train your body to love instant, you just need to stick with it.

"I only eat dollar store steak and your body needs calories so your taste will adapt." You can say this about literally any food. Nonsense.

As a German... do.. do your dollar stores actually have steaks?

Scary thought.

Re: Intermittent fasting works – not only for weight loss but also for heart health

#106

It "works" exactly like calorie restriction, there's no magic to IF. From a literature review[0]: >Twelve studies used calorie-restricted diets as a comparator to IF and found equivalent weight loss in both groups.11,15-17,19,22,27,28,33,41-43 Study duration was 8 weeks to 1 year, with a combined total of 1206 participants (527 undergoing IF, 572 using calorie restriction, and 107 control participants) and demonstrat…

> It "works" exactly like calorie restriction[;] there's no magic to IF.

This phrasing is too easily misinterpreted.

Saying "works" leaves ambiguity between outcomes (i.e. weight loss results) and processes (i.e. metabolic mechanisms and changes). If you said "IF showed similar results as CR in treating obesity" that is consistent with the paper.

Second, saying "exactly like" in the context of statistics is an effective way to invite criticism (and not the constructive kind).

From the key points on the front page:

  > The heterogeneity in the current evidence limits
  > comparison of IF to other weight-loss strategies.
  > Intermittent fasting shows promise as a primary care
  > intervention for obesity, but little is known about 
  > long-term sustainability and health effects. 
  > Longer-duration studies are needed to understand
  > how IF might contribute to effective weight-loss
  > strategies.

Re: Intermittent fasting works – not only for weight loss but also for heart health

#107
post #23

Earlier quoted context omitted.

> For most people I'd recommend exercise instead of fasting. "You can't outrun the fork." Metabolic studies show that you have to be damn near Olympic calibre in your exercise routine to cause a significant change in caloric consumption by increasing metabolism through exercise. Your body pretty much holds a constant level of metabolism and shunts it around to whichever systems it deems most important right now . Exe…

I know this is the standard advice and surely people need to pay attention to their diet, but exercise is not so marginal. For example running or swimming for an hour seems to be around 8-900 kcal based on various websites. Now that's not nothing, but also people won't do it daily for sure. I think nutrition advice is really hard because people already (have to) factor in the likelihood of following the advice by a g…

> But regular exercise all else equal does have a significant effect. Yes, nothing is all else equal...

Right, and that's the problem. Even if you do avoid "cheating" and "I ran X miles so I deserve this" type things, your body will still mess with your metabolism to compensate for the added exercise, and that works against the weight loss plan.

I went from near-zero exercise to ~10 miles of running per week, and maintained that more or less for 2 years without experiencing any significant weight loss (it was/is definitely valuable for general cardiovascular health, though). Only changing my diet helped, and even then it was difficult to lose weight and keep it off (took a year to lose ~7 lbs, and less than half that to put them back one). But now with COVID-19 and sheltering in place, I've been cooking nearly every day, and in less than three months have lost 15 lbs, and I've been running less than usual.

But really, everyone's individual experience differs. It seems like nutrition and exercise advice really needs to be tailored to each person, and sometimes there's a bit of trial and error involved.

Re: Intermittent fasting works – not only for weight loss but also for heart health

#108

He lost 45 lbs, that’s what probably removed his sleeps apnea. Not because of some other magical ability of intermittent fasting. One of my friends also lost a lot of weight and his apnea went away, he went off of his CPAP machine.

You're probably correct, in that losing a lot of weight greatly improved his health. That said, losing weight is freaking difficult, and if intermittent fasting is a path towards that, it'd be very useful. I've done a lot of fasting. The results seem pretty good. Pulling it off is non-trivial. At this point, we need "magical", because nothing else has really seemed to work in general for losing weight. (And no, didn'…

Weight loss is in theory very simple - just eat less. In practice, however, doing that is extremely hard (for a lot of people), as it goes against our upbringing and evolutionary and social pressures.

The key of any weight-loss diet is that it somehow hacks our brain so that we end up eating less. But everyone’s brain is different, so different hacks work (or not) for different people. That’s why you have so many diets - fasting, intermittent fasting, keto, paleo, zero carb, low fat, food separation diet, ...

Personally, intermittent fasting hasn’t helped me lose weight (might have helped me maintain it though). So far, the only thing that has helped was very strict calorie counting, but that was accompanied with severe emotional/mental discomfort (constant hunger). I’m now experimenting with one-day fasting (turns out not eating, for me, is associated with less hunger than eating too little, go figure ...), we’ll see how t goes.

Re: Intermittent fasting works – not only for weight loss but also for heart health

#109

He lost 45 lbs, that’s what probably removed his sleeps apnea. Not because of some other magical ability of intermittent fasting. One of my friends also lost a lot of weight and his apnea went away, he went off of his CPAP machine.

Apnea can lead to binge eating, so it may be the apenea was in part responsible for gaining the 45 lbs!

> Apnea can lead to binge eating

How so ?

Re: Intermittent fasting works – not only for weight loss but also for heart health

#110

It "works" exactly like calorie restriction, there's no magic to IF. From a literature review[0]: >Twelve studies used calorie-restricted diets as a comparator to IF and found equivalent weight loss in both groups.11,15-17,19,22,27,28,33,41-43 Study duration was 8 weeks to 1 year, with a combined total of 1206 participants (527 undergoing IF, 572 using calorie restriction, and 107 control participants) and demonstrat…

> It "works" exactly like calorie restriction, there's no magic to IF.

"there's no magic to IF"? Well, literally speaking, I tend to agree. For example, I've never actually made out any mustachioed magical monkeys monkey-patching methods in Ruby on Rails.

Seriously though, I think I disagree with the intent behind your sentence, which I interpret as downplaying the difference between IF (intermittent fasting) and CR (calorie restriction). Based on reading the Obesity Code, my understanding is that IF leads to substantially different biological responses relative to CR.

This diagram below, or something similar to it, is a nice way of understanding the core principles in The Obesity Code by Fung which promotes IF. Sustained durations of fasting help lower insulin levels for long enough periods that insulin resistance itself can lower. (CR doesn't do this, to my knowledge.)

  ASCII Diagram version of
  https://thefastingmethod.com/wp-content/uploads/HOT-Fatty-Liver2.1.jpg 

                         ┌────────┐                       
  ┌───────────┐          │  high  │          ┌───────────┐
  │  glucose  │────┬────▶│insulin │────┬────▶│  obesity  │
  └───────────┘    │     └────────┘    │     └───────────┘
                   │                   │                  
                   │                   ▼                  
            ┌────────────┐      ┌─────────────┐           
            │  insulin   │      │    fatty    │           
            │ resistance │◀─────│    liver    │           
            └────────────┘      └─────────────┘           
                                       ▲                  
                                       │                  
                                       │                  
                                ┌────────────┐            
                                │  fructose  │            
                                └────────────┘
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