The Study
Intermittent fasting has
been proposed as a method of weight loss in recent years. However, questions
remain as to whether it is an effective and safe strategy to manage body
weight. A recently published investigation attempts to answer this question. Eighteen
men and women completed two three day trials in a crossover design. On the
first day, subjects consumed 100% of their energy needs. On the second day, a
standardized breakfast was consumed, hormones and appetite were measured and an
all you can eat breakfast and lunch was served to all subjects. On day three,
an all you can eat breakfast was offered. The second trial started with
subjects consuming only 25% of energy needs. Days 2 and 3 in the second trial were
identical to the first trial.
There were several
important results reported:
1) When subjects
restricted their energy intake on day 1, they consumed 7% more energy on day 2.
By day 3, they consumed no more calories than they did when they did not fast.
2) Appetite was higher on
day 2 when subjects fasted, but not different on day 3.
3) Blood glucose was
significantly higher after energy restriction.
4) Energy expenditure was
significantly lower on the morning of day 2 after fasting. American Journal of Clinical Nutrition 2016; 104:1545-53.
Take Home Message
This is a fascinating
study to me. I have never recommended fasting as a method of weight loss. Is it
effective? In the short term, probably. I would argue that it is not in the
long term. I think you win the battle but lose the war by fasting. While you
will certainly lose some weight, it is my opinion that starving yourself recruits some of our body’s most effective
defense mechanisms. Specifically, metabolic rate is slowed and we start to burn
muscle in an effort to spare body fat. This combination makes long term weight
loss virtually impossible.
A lot of my concerns about
fasting were validated by this study:
1) Subjects were very
hungry the day of the fast and even the second day as well. This makes
compliance tough because most people are pretty miserable when they are hungry
and won’t let themselves stay hungry for long.
2) Subjects consumed more
calories the next day than if they had eaten normally.
3) Their energy expenditure
was lower the next day. In other words, the fasting seemed to slow down their
metabolism. Not good.
4) Most concerning was
that their blood sugar and insulin levels were significantly greater when they
fasted. This indicates impaired glycemic control, which is not a good thing at
all.
5) On a side note, if you
are cutting your calories by 75% up to 4 days per week, it is going to be
impossible to get enough vitamins, minerals, antioxidants, fiber, etc on those
days. These nutrients are hugely important for our health and for chronic
disease risk reduction.
In conclusion, there are no
shortcuts to losing weight. It takes a lot of work, but the path to a healthy
weight and a healthy body is a combination of a balanced diet, a good cardiovascular
exercise program and consistent resistance training.
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