WWW Dietdoctor Com Intermittent Fasting
WWW Dietdoctor Com Intermittent Fasting
WWW Dietdoctor Com Intermittent Fasting
for beginners
By Dr. Jason Fung, MD , medical review by Dr. Andreas Eenfeldt, MD – Updated May 21, 2019 Evidence based
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Intermittent fasting is a way to cycle between periods of fasting and eating. It’s currently a
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very popular method to lose weight and improve health.
I agree
Intermittent fasting might actually be an ancient secret of health. It is ancient because it
has been practiced throughout all of human history. 1 It’s a secret because this
potentially powerful habit had until recently in many ways been virtually forgotten. 2
However, many people are now re-discovering this dietary intervention. Since 2010, the
number of online searches for “intermittent fasting” has increased by about 10,000
percent, with most of the increase happening in the last few years. 3
Intermittent fasting might provide huge benefits if it is done right, including loss of excess
weight, reversal of type 2 diabetes and many other things. 4 Plus, it can save you time
and money.
The goal of this beginner’s guide is to provide everything you need to know about
intermittent fasting, in order to get started.
This guide is written for adults with health issues, including obesity, that could
benefit from intermittent fasting. Learn more.
People who should NOT fast include those who are underweight or have eating
disorders like anorexia, women who are pregnant or breastfeeding, and people
under the age of 18. Learn more.
No. Fasting differs from starvation in one crucial way: control. Starvation is the involuntary
absence of food for a long time, leading to severe suffering or even death. 5 It is neither
deliberate nor controlled.
Fasting, on the other hand, is the voluntary withholding of food for spiritual, health, or
other reasons. It’s done by someone who is not underweight and thus has enough stored
body fat to live off. Intermittent fasting done right should not cause suffering, and certainly
never death.
Food is easily available, but you choose not to eat it. This can be for any period of time,
from a few hours up to a few days or – with medical supervision – even a week or more. You
may begin a fast at any time of your choosing, and you may end a fast at will, too. You can
start or stop a fast for any reason or no reason at all.
Fasting has no standard duration, as it is merely the absence of eating. 6 Anytime that
you are not eating, you are intermittently fasting. For example, you may fast between
dinner and breakfast the next day, a period of approximately 12-14 hours. In that sense,
intermittent fasting should be considered a part of everyday life.
Intermittent fasting is not something queer and curious, but a part of everyday, normal life.
It is perhaps the oldest and most powerful dietary intervention imaginable. 7 Yet
somehow we have missed its power and overlooked its therapeutic potential.
To get started, either watch our brief video course on intermittent fasting, or keep reading
below.
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Do you want to keep watching? Part 2: How to maximize fat burning
At its very core, intermittent fasting simply allows the body to use its stored energy. For
example, by burning off excess body fat. 8
It is important to realize that this is normal and humans have evolved to fast for shorter
time periods – hours or days – without detrimental health consequences. 9 Body fat is
merely food energy that has been stored away. If you don’t eat, your body will simply “eat”
its own fat for energy.
Life is about balance. The good and the bad, the yin and the yang. The same applies to
eating and fasting. Fasting, after all, is simply the flip side of eating. If you are not eating,
you are fasting. Here’s how it works:
When we eat, more food energy is ingested than can immediately be used. Some of this
energy must be stored away for later use. Insulin is the key hormone involved in the
storage of food energy.
Insulin rises when we eat, helping to store the excess energy in two separate ways.
Carbohydrates are broken down into individual glucose (sugar) units, which can be linked
into long chains to form glycogen, which is then stored in the liver or muscle.
There is, however, very limited storage space for carbohydrates; and once that is reached,
the liver starts to turn the excess glucose into fat. This process is called de-novo
lipogenesis (meaning literally “making new fat”). 10
Some of this newly created fat is stored in the liver, but most of it is exported to other fat
deposits in the body. While this is a more complicated process, there is almost no limit to
the amount of fat that can be created.
So, two complementary food energy storage systems exist in our bodies. One is easily
accessible but with limited storage space (glycogen), and the other is more difficult to
access but has almost unlimited storage space (body fat).
The process goes in reverse when we do not eat (intermittent fasting). Insulin levels fall,
signaling the body to start burning stored energy as no more is coming through food.
Blood glucose falls, so the body must now pull glucose out of storage to burn for energy.
Glycogen is the most easily accessible energy source. It is broken down into glucose
molecules to provide energy for the body’s other cells. This can provide enough energy to
power much of the body’s needs for 24-36 hours. After that, the body will primarily be
breaking down fat for energy. 11
So the body only really exists in two states – the fed (insulin high) state and the fasted
(insulin low) state. Either we are storing food energy (increasing stores), or we are burning
stored energy (decreasing stores). It’s one or the other. If eating and fasting are balanced,
then there should be no net weight change.
If we start eating the minute we roll out of bed, and do not stop until we go to sleep, we
spend almost all our time in the fed state. Over time, we may gain weight, because we
have not allowed our body any time to burn stored food energy. 12
To restore balance or to lose weight, we may simply need to increase the amount of time
spent burning food energy. 13 That’s intermittent fasting.
In essence, intermittent fasting allows the body to use its stored energy. After all, that’s
what it is there for. The important thing to understand is that there is nothing wrong with
that. That is how our bodies are designed. That’s what dogs, cats, lions and bears do.
That’s what humans do.
If you are eating every third hour, as is often recommended, then your body will constantly
use the incoming food energy. It may not need to burn much body fat, if any. You may just
be storing fat. 14 Your body may be saving it for a time when there is nothing to eat.
Fasting offers many important unique advantages that are not available in typical diets.
Where diets can complicate life, intermittent fasting may simplify it. Where diets can be
expensive, intermittent fasting can be free. Where diets can take time, fasting saves time.
Where diets may be limited in their availability, fasting is available anywhere. And as
discussed earlier, fasting is a potentially powerful method for lowering insulin and
decreasing body weight.
Here are even more reasons to try it, along with more details: The 7 practical benefits of
intermittent fasting
Intermittent fasting results
More intermittent fasting results
16:8
This way of doing intermittent fasting involves daily fasting for 16 hours. Sometimes this is
also referred to as an 8-hour eating ‘window’. You eat all your meals within an 8-hour time
period and fast for the remaining 16 hours. Generally, this is done daily or almost daily.
For example, you may eat all your meals within the time period of 11:00 am and 7:00 pm.
Generally, this means skipping breakfast, but some people prefer to skip dinner instead.
You typically eat two or three meals within this 8-hour period.
20:4
This involves a 4-hour eating window and a 20-hour fast. For example, you might eat
between 2:00 pm and 6:00 pm every day and fast for the other 20 hours. Generally, this
would involve eating either one meal or two smaller meals within this period.
5:2 fast
This is the version of intermittent fasting that has the most scientific support, as most
studies on intermittent fasting has featured similar advice. 30 Dr. Michael Mosley
popularized this variation of intermittent fasting in his book ‘The Fast Diet’.
5:2 involves five regular eating days and two fasting days. However, on these two fasting
days, you are allowed to eat 500 calories on each day. These calories can be consumed at
any time during the day – either spread throughout the day or as a single meal. Learn more
Alternate-day fasting
Another related approach to 5:2 is to have “fasting” days with 500 calories not just twice a
week, but every other day. Learn more
36-hour fasts
This involves fasting for the entire day. For example, if you eat dinner on day 1, you would
fast for all of day 2 and not eat again until breakfast on day 3. This is generally 36 hours of
fasting. This might provide a more powerful weight loss benefit. The other great benefit is
that it avoids the temptation to overeat dinner on day 2. Learn more
Extended fasting
Generally for fasts greater than 48 hours, I recommend a general multivitamin to avoid
micronutrient deficiency. The world record for fasting is 382 days, and going 7-14 days may
be possible for some people. 31
I discourage people from fasting for more than 14 days due to high risk of refeeding
syndrome, a dangerous shift in fluids and minerals that can occur when food is re-
introduced after a long fast. 32
You can probably fast, but may need medical supervision, under these conditions:
If you have any serious medical conditions, such as liver disease, kidney disease, or
heart disease.
metabolic rate (at least initially) and might potentially improve overall body composition.
34 Learn more
However, for long duration aerobic exercise, eating before exercise may increase
performance. 36 This is good to know if you’re competing.
Keep in mind that it may be important to drink fluids and replenish sodium (salt) around
exercise when fasting. Learn more
Hunger is the most common side effect of intermittent fasting. This may be less of an
issue if you’re already on a keto or low-carb, higher-fat diet. 38 Learn more.
Constipation is common. Less going in means less going out. You don’t need
medications unless you experience discomfort. Standard laxatives can be used to
help.
Headaches are common and tend to disappear after the first few times on fasts. 39
Other possible side effects include dizziness, heartburn and muscle cramps. Learn
more
A more serious side effect is the refeeding syndrome. Fortunately, this is rare and
generally only happens with extended fasts (5-10 days or more) when one is
undernourished. Learn more
During extended fasts, hunger will often increase into the second day. After that, it
gradually recedes; and many people report a complete loss of hunger sensation by day 3-
4. 44 Your body is now being powered by fat. In essence, your body is ‘eating’ its own fat
for breakfast, lunch and dinner and therefore is no longer hungry. Learn more
Won’t intermittent fasting burn muscle?
Not really. During fasting, the body first breaks down glycogen into glucose for energy.
After that, the body increases fat breakdown to provide energy. Excess amino acids (the
building blocks of proteins) are also used for energy, but the body does not burn its own
muscle for fuel unless it has to. 45
It would be a long stretch of the imagination to think that our bodies store energy so
carefully in the form of glycogen and fat only to burn muscle when it is needed.
In my experience with over 1,000 patients on various intermittent fasting regimens, exactly
zero have complained that they have noticed significant muscle loss. 46 Learn more
Drink water
Stay busy 47
If people are not supportive of you intermittently fasting for health reasons, you don’t
have to tell them
Give yourself one month to see if intermittent fasting (such as 16:8) is a good fit for
you
Follow a low-carb diet between fasting periods. This reduces hunger and makes
intermittent fasting easier. 49 It may also increase the effect on weight loss and type 2
diabetes reversal, etc. 50
Eating too large a meal after fasting (a mistake that we have ALL done, myself included)
can give you a stomach ache. While this is hardly serious, people usually learn quickly to
eat as normally as possible after a fast.
Furthermore, for women trying to conceive, be aware that – perhaps especially for athletic
women with low body fat percentage – intermittent fasting might increase the risk of
irregular menses, and lower the chance of conception. 54
Other than that, there is no special reason why women should not fast. 55 Women can
have problems during intermittent fasting, but so can men. Sometimes women do not get
the results they want, but that happens to men, too.
Studies show that the average weight loss for women and men who fast is similar. 56
Fasting may reduce calories but its benefits extend far beyond that. 58 Learn more
In theory it’s of course possible to eat more after fasting, cancelling out the weight lost. But
studies generally show that people tend to end up eating significantly less overall. 60
I call intermittent fasting “the ancient secret of weight loss” because it might be one of the
most powerful dietary interventions for weight loss, yet it has been mostly ignored by
doctors and dieticians for a long time. 61 Learn more
More Q&A
Many more questions and answers about intermittent fasting
Start fasting. If you do not feel well, or if you have any concerns, then stop
Continue all your usual activities outside of eating. Stay busy and live normally.
Imagine you’re “eating” a full meal of your own fat
Repeat
If you want to, you can jump straight to the get-started sections of the course:
The left one below is about how to do a 24-hour fast (it’s surprisingly simple).
The right one is a real challenge, a 7-day fast (are you up for it?).
Presentations
Books
Dr. Fung’s books The Obesity Code, The Complete Guide to Fasting and The Diabetes
Code are available on Amazon. 62