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The Skinny on Intermittent Fasting

The Skinny on Intermittent Fasting

You’ve probably heard about intermittent fasting which, according to Google, was the most searched diet trend of 2019.  The practice of fasting has been around since ancient times. Hippocrates, widely considered the father of modern medicine, was a staunch supporter.  Fasting for spiritual purposes is widely practiced and is a component of virtually every major religion in the world, considered to be a cleansing and purifying process for both the body and the spirit. Numerous studies suggest intermittent fasting has a beneficial effect on a wide range of chronic disorders including cardiovascular disease, diabetes, cancer, autoimmunity, and neurodegenerative brain diseases such as Alzheimer’s and Parkinson’s.  But can it also help us lose weight and, more importantly, keep the weight off permanently?

 

What is intermittent fasting?

The basic principle of intermittent fasting is simple: abstain from eating during specific time periods and eat during others. The 3 most common variations are:

 

  1. Daily time-restricted eating: this involves eating all your meals for the day within a certain window of time, typically anywhere from 4-12 hours (meaning you’ll be fasting for 12-20 hours of the day). For example, if you stop eating by 8 p.m. then have your first meal at noon, you will have created a 16-hour fasting state.
  2. Alternate day fasting: this involves alternating “feed days”, where you eat normally, with “fast days”, where eating is restricted to one meal of ~500 calories, ideally consisting of protein, healthy fats, and vegetables (i.e. no refined starches or sugars)
  3. 5:2 intermittent fasting: in this plan, you eat normally five days of the week and drastically reduce calories on the other two days, typically 500 calories for women and 600 calories for men.

Which plan is best for you?  There is no single right answer and in fact, most people find it beneficial to switch things up periodically.  In general, it is recommended to start slowly and gradually increase your fasting window in order to avoid unpleasant side effects that can discourage you from continuing.  There is some evidence to suggest that timing your eating window earlier in the day, say from 8a.m. to 2 p.m., can help normalize cortisol expression and circadian rhythms. 

 

How does intermittent fasting work?

 

Calorie reduction:


At its most superficial level, intermittent fasting can reduce the total number of calories we consume.  Although there are no specific calorie limits set, restricting our eating to a limited number of hours naturally tends to limit the amount of food we eat, particularly in the evenings when many of us plunk ourselves down on the couch to watch TV while mindlessly munching on high calorie, highly processed snack foods. 

 

Facilitates ketosis:

In a prolonged fasting state, once the body has used up its reserves of glucose, it starts burning fat for fuel. Decreasing the body’s excess fat stores, particularly the visceral fat deposits (around the abdominal organs) is integral to healthy and long-lasting weight loss.

 

Metabolism boost:

One common misconception that makes many people reluctant to try fasting is the idea that it causes our basal metabolism to decrease—the so-called “starvation mode”, making it harder to lose weight in the long run. In fact, fasting causes an increase in metabolic rate, mediated by an increase in adrenaline as well as growth hormone.  Presumably, this serves as an adaptive response to give us the energy to go out and find food in times of scarcity.  Humans as a species would not have survived very long if the body’s response to missing a few meals was to shut down completely. Growth hormone also helps the body utilize fat for fuel and preserve muscle mass and bone density.  Ironically, daily calorie reduction, not fasting, does in fact lead to decreased metabolism, as the body matches lower food intake with lower energy expenditure.  When food intake goes to zero, however, the body switches its energy source from ingested food to its own stored fat reserves which provide ample energy for maintaining metabolism.  Alternating between a fed state and a fasting state is therefore more important than simply reducing overall calories. 

 

Decreased insulin and insulin resistance:

The root cause of obesity in many cases is persistently high levels of insulin leading to insulin resistance, increased fat storage, and a higher body weight set point.  The body weight set point is monitored by the hypothalamus but appears to be set higher by higher levels of insulin.  When we attempt to lose weight by the standard method of eating less and exercising more, the hypothalamus acts to maintain the set point by decreasing our energy expenditure (by decreasing metabolic rate, body temperature, etc) and increasing appetite. Therefore, further weight loss becomes more and more difficult, and over time we tend to regain that weight and then some.  Breaking the insulin-resistance cycle and lowering the body weight set point to allow long-term weight loss requires recurrent periods of very low insulin levels. Since all food stimulates an insulin response to some degree (with refined starches and sugars being the worst offenders), the best way to achieve this is via fasting. 

 

Contraindications for fasting

Although intermittent fasting can be a powerful tool for losing weight and improving overall health, it is not for everyone. Women who are pregnant or breastfeeding should not practice intermittent fasting so as not to compromise their baby’s nutritional needs.  Likewise, children under 18 should not fast for extended periods, nor should anyone underweight (e.g. body mass index (BMI) less than 18.5).  The strict eating schedule may also act as a trigger for those with a history of anorexia or other eating disorder.  

Individuals taking medications, especially diabetics, must exercise caution and require medical supervision when undertaking an intermittent fasting program, as does anyone with pre-existing medical conditions such as kidney disease, cardiovascular disease, and adrenal issues. 

Susan Goto, ND

 

References:

De Cabo, R, Mattson, MP. Effects of Intermittent Fasting on Health, Aging, and Disease. N Engl J Med, 2019, 381(26): 2541-2551.

Ferrannini E, Natali A, Bell P, et al. Insulin resistance and hypersecretion in obesity. J Clin Invest. 1997 Sep 1; 100(5):1166–73.

Harvie MN et al. The effects of intermittent or continuous energy restriction on weight loss and metabolic disease risk markers. Int J Obes (Lond). 2011 May; 35(5):714–27.

Heilbronn LK. Alternate-day fasting in nonobese subjects: effects on body weight, body composition, and energy metabolism. Am J Clin Nutr. 2005; 81:69–73.

Jamshed, H; Beyl, RA; Della Manna, DL; Yang, ES; Ravussin, E; Peterson, CM. Early Time-Restricted Feeding Improves 24-Hour Glucose Levels and Affects Markers of the Circadian Clock, Aging, and Autophagy in Humans. Nutrients, 2019, 11, 1234. 

Leibel RL, Hirsch J. Diminished energy requirements in reduced-obese patients. Metabolism. 1984 Feb; 33(2):164–70.

Lustig R. Hypothalamic obesity: causes, consequences, treatment. Pediatr Endocrinol Rev. 2008 Dec; 6(2):220–7.

Stubbs RJ et al. Effect of an acute fast on energy compensation and feeding behaviour in lean men and women. Int J Obesity. 2002 Dec; 26(12):1623–8.

The Benefits of B vitamins

The Benefits of B vitamins

A vitamin is an essential nutrient. The human body cannot create its own vitamins, and if a specific vitamin is missing, predictable symptoms will occur. For example, if you don’t eat enough vitamin C symptoms of scurvy may appear. B vitamins are commonly prescribed in Naturopathic practice as they are an important part of good health and managing stress.

B vitamins are a group of water-soluble compounds which support energy production in cells. Most vitamins were discovered in the first half of the 20th century. Have you ever wondered why there is no vitamin B4? As we learn more about vitamins, science has revealed that some compounds which had been labeled as vitamins were in fact non-essential. The body could produce it’s own, or the compound was not needed for proper functioning. It’s kind of like when Pluto lost its planet status!

Why do we care about the demoted B vitamins? Orthomolecular medicine uses targeted doses of nutritional compounds to produce a therapeutic effect in the body. Although you won’t be deficient in vitamin B4, it may still help treat symptoms.


Formerly known as: Vitamin B4
Current name: Choline 

Choline’s biggest role in the body is being used to make acetylcholine which plays an important role in muscle contraction, hormone regulation and sleep. Choline is also involved in brain development, the formation of various lipids and works as a methyl donor. Genetic variations in methylation may play a role in depression.

Choline is being researched for it’s a potential role in treating fatty liver disease, high homoysteine, blepharospasm, hyperthyroidism and bipolar disorder.

 

Formerly known as: Vitamin B8
Current name: Inositol

Inositol exists in two forms, myo-inositol and D-chiro-inositol. Inositol is used to make phospholipids which are a key component of cell membranes. They are also used in the phosphatidylinositol cycle which is linked to the noradrenergic, serotonergic and cholinergic receptors. These receptors are important for alertness, mood regulation and muscle function. Inositol can also support uptake of glucose into the cells, leading to decreased sugar in the bloodstream.

Inositol may have the potential to prevent depression, diabetes, nonalcoholic fatty liver disease, polycystic ovarian syndrome and Alzheimer’s disease. It is also a favorite compound recommended by Cathryn Coe, ND to improve sleep, lower BP and cholesterol, and support balanced testosterone levels. *Note that inositol in any form is contraindicated in bipolar disorder as it may exacerbate symptoms.

 

Formerly known as: Vitamin B10
Current name: PABA

Research suggests PABA can increase the effect of estrogen and glucocorticoids in the body. As glucocorticoids have a strong anti-inflammatory effect on the body, it may have a therapeutic role in autoimmune conditions such as scleroderma, dermatomyositis, Dupuytren’s contracture, Peyronie’s disease. PABA is also used to make folic acid.

Most commonly, B vitamins are recommended in a B complex for patients experiencing stress, fatigue, low mood and difficulty losing weight. Feeling better overall helps us reach our health goals and can improve our sense of well being. Remember to take your B’s earlier in the day, with breakfast or lunch, and always with food.

 

References:

Carpenter K, Baigent M. vitamin | Definition, Types, & Facts. Encyclopedia Britannica. https://www.britannica.com/science/vitamin. Published 2019. Accessed December 7, 2019.

Pizzorno J. Textbook Of Natural Medicine. St. Louis, Mo.: Elsevier/Saunders; 2013.

Pintaudi B, Di Vieste G, Bonomo M. The Effectiveness of Myo-Inositol and D-Chiro Inositol Treatment in Type 2 Diabetes. Int J Endocrinol. 2016;2016:1-5. doi:10.1155/2016/9132052

Frank K, Patel K Examine.com. https://examine.com/. Published 2019. 

B  vitamins. En.wikipedia.org. https://en.wikipedia.org/wiki/B_vitamins. Published 2019. Accessed December 7, 2019.

 

Can stress make my hot flashes worse?

Can stress make my hot flashes worse?

What are Hot Flashes?

Hot flashes are just one of many symptoms that can occur in perimenopause or menopause. There is an intricate pathway of hormones that come into play with regards to balancing hormones. Once key thing to remember is the role that the adrenal glands play in keeping our hormones balanced and supporting us in being symptoms free.

When we enter into our mid 40’s (or earlier for some women with premature ovarian failure), our adrenal glands begin to take a front seat to our hormone health. The adrenal glands are our “fight or flight” hormone producing glands. They produce the hormones that respond to panic, or keep up awake for long hours for those working in emergency setting. The adrenal glands also regulate blood pressure, blood sugar, and produce sex hormones. So if you are in a continuous state of stress, we can notice symptoms in all of these areas. High blood pressure or low blood pressure. Shakiness when we don’t eat regularly. Increased feelings of stress and overwhelm. And all of the symptoms of hormone imbalance. Hot flashes, insomnia, low sex drive and weight gain, just to name a few.


What can you do?

If you feel that stress is a culprit for your hot flashes, consider the following actions:

  1. Try and stick to a regular schedule for meals, exercise and sleep. Bedtime by 10pm is ideal. Keep your workout light. Exercise exhaustion puts further stress on the adrenal if you are not conditioned properly.
  2. Eat protein with each meal. Protein stabilizes blood sugar and keeps you from feeling shaky, and reaching for foods that are less than healthy.
  3. Try a B complex. Most people tolerate a B complex very well. Please take with food as it will cause nausea without food. It will also turn the urine bright yellow. This is completely normal.
  4. Pick 30 min a day to deal with the most stressful things on your list or in the news. 60 minutes might be more realistic for some, but let yourself really feel what you are feeling every day. I recommend the same for people who are grieving a loss. These feelings are much the same right now for most of us.
  5. Limit caffeine intake. If you have caffeine, have it with food and choose organic. Coffee and tea are very heavily sprayed and can be considered endocrine disruptors.
  6. Seed rotation. This is pretty old school Naturopathic Medicine, but it works! From the new moon to the full moon, incorporate ground flax and pumpkin seeds in your diet. From the full moon to the new moon, do the same with sunflower and sesame seeds. Nut butters work too. These combinations boost estrogen and progesterone, respectively.

Cathryn Coe, ND is a licensed Naturopathic Physician and owner of Edgemont Naturopathic Clinic.