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The Skinny On Intermittent Fasting

Published Jul 3, 2013

The British Invasion is happening all over again, except this time, we’re importing the latest weight loss craze instead of infectious rock music. The hottest diet trend in the UK – intermittent fasting – is now taking off in the US. While these fasting diets come in range of shapes and sizes, all of them are variations on the same basic theme: on select days of the week, you heavily restrict your calories to help you shed pounds. The rest of the time, you eat a typical calorie load (in many cases, you decide what’s “typical”). Because you’re only restricting your food intake a few days a week instead of 24/7, proponents say you feel less deprived and are more likely to stick with the diet long enough to see results…but there are some downsides to consider, too.

The bestselling book The FastDiet kicked off the fasting frenzy in England earlier this year. This plan advocates what is referred to as “5:2 intermittent fasting” – two days a week, dieters limit themselves to 500 calories (or 600 if they’re male), and the remaining five days, they eat normally. The book’s author, UK medical television journalist Dr. Michael Mosley, claims that fasting can help you shed pounds quickly, and also improve your blood pressure, cholesterol, and insulin sensitivity.

Another popular plan, the 2-Day Diet, takes a slightly different approach. This book, which made its US debut just a few weeks ago, instructs dieters to eat a low-carbohydrate, low-cal menu (around 1,000 calories for females and 1,100 for males) on two restricted days each week and a heart-healthy, Mediterranean-style diet on five unrestricted days.

The Science of Fasting

Dr. Michelle Harvie, author of the 2-Day Diet, based the plan on intermittent fasting studies she conducted as a research dietitian at the Genesis Breast Cancer Prevention Center in England. In one study, published in 2011, Harvie and her colleagues assigned 107 overweight and obese women to one of two weight loss plans. Half of the participants followed a traditional, or “continuous diet” – every day, they ate 25 percent fewer calories than their daily calorie requirement. The second group also reduced their total weekly calories by 25 percent, but instead of spreading the deficit out over seven days, they cut their calories more severely for just two days a week (the women ate about 650 calories on the two fasting days). Both groups lost the same amount of weight – around 13 pounds in 6 months, on average – and saw similar improvements in cholesterol levels, blood pressure, and other health indicators.

Supporters cite this research as evidence that intermittent fasting is an effective way to shed excess pounds. But viewed from another angle, the study shows that fasting doesn’t offer a significant advantage over the classic dieting approach. It’s no surprise that the women dropped the same number of pounds, regardless of which plan they followed. “Calories in versus calories out” is the most important determinant of weight loss, and if you cut the same number of calories over the course of a week, when you cut those calories shouldn’t make a difference. Either method can work as long as you stick with it. However, that’s precisely where the fasting method can get tricky.

The basic premise of these trendy new diets is that it’s easier to diet two days a week than seven, and in Harvie’s 2011 study, those following the intermittent fasting plan did report slightly higher adherence rates than those assigned to the traditional diet. But participants’ responses at the completion of the study are telling. Only 58 percent of those on the two-day partial fasting plan intended to continue their assigned diet after the trial ended. On the other hand, 85 percent of those following the continuous diet reported that they would stick with their plan.

Don’t Overlook the Diet’s Drawbacks

The truth is, fasting – even partial fasting, as in the case of these new diet plans – can be uncomfortable and difficult to sustain. Many people report feeling weak, dizzy, or fatigued when they slash their food intake to 500 or 600 calories a day. And dramatically reducing calories for a day or two can leave you feeling ravenous, which can lead to binging. Have you ever skipped meals or vowed to eat really lightly one day, only to find yourself going whole hog at the end of the day because your stomach is gnawing at itself – or you just can’t stop thinking about food? This sort of on-off diet mentality can be especially problematic for people who struggle with emotional eating. If things get out of control, it can fuel a vicious cycle of restricting and overeating that often leads to weight gain – and an unhealthy relationship with food.

The 2-Day Diet approach has other disadvantages. Not only are the calorie totals and portion sizes fluctuating from day to day, but so is the eating style. One day you’re doing low-carb, the next Mediterranean. Now imagine trying to keep your food plan straight while trying to balance work, family, and other responsibilities…and maintain a social life. Weight loss just doesn’t need to be this complicated, and it’s this type of unnecessary frustration that makes dieting seem so impossible when it really can be very manageable and realistic. What’s more, for some, the 2-Day Diet may not even create a large enough calorie deficit to support steady weight loss. Some middle-aged women, particularly those who aren’t very active or don’t have much to lose, need to limit themselves to 1,200 calories a day to successfully slim down. Cutting calories to 1,000 two days a week – and eating “regular” portions the rest of the week – may not be sufficient to move the scale.

If you cut enough calories, there’s no question that intermittent fasting can lead to successful weight loss, at the least in the short term. But for many people, it’s a difficult eating pattern to sustain for more than a few weeks or months. If you do choose to give intermittent fasting a try (and you cleared it with your doctor), you could probably do it on your own, without the help of a diet book. Follow a healthy, balanced meal plan with plenty of vegetables, fruit, lean proteins, whole grains, and other nutrient-dense foods, and instead of trimming your calories moderately every day, try cutting calories more dramatically two or three days a week. (To get a baseline, use this simple calculator to determine how many calories you need to maintain your current weight – then subtract from there.) But make sure you take your personality into account when making a decision. If you know from experience that overly restricting yourself has negative repercussions (for many, it does), I strongly recommend adopting a more traditional approach, shaving a bit each day.



Make Little Changes for Big Weight Loss

Weight loss can feel overwhelming. With big goals, it can seem like you aren’t making the progress you want, which leads to diminished motivation. So let’s try to make small goals– making little lifestyle changes really add up to the bigger goals you want to achieve. Try these today.

1. Eat protein at breakfast– like eggs! Protein keeps you fuller longer than that bagel or blueberry muffin. You’ll be less likely to eat more later on.

2. Eat more fresh fruit and veggies… skip the canned version for a healthier choice.

3. Park your car far away so you’ll walk more steps and burn more calories (or walk instead of drive!)

4. Switch to 100% whole grains… who needs white bread when you have so many whole grain options?

5. Get more fiber. It also keeps you fuller and helps with digestion.

6. Drink at least 8 classes of water. You’ll eat less and feel better.

7. No more soda and sugary fruit juice… and that’s final!

8. Drink light beer instead of regular beer, choose a low cal cocktail made with club soda over the ones made with soda & fruit juice, limit your wine portions.

9. Don’t eat in front of the TV. You’ll be more likely to eat mindlessly.

10. Cook with heart healthy olive oil not butter or other fats.

11. Start with soup or salad– you’ll eat less of your entree.

12. Keep a little dark chocolate on hand to satisfy your sweet tooth– so you won’t dig into that pint of ice cream.

13. No more fast food. No excuses.

14. That goes for processed foods too!

15. Add strength training to your exercise regimen. More muscle=more calories burned all day long.

16. Use a pedometer, try to walk more steps every day!

17. Log your calories in the food and fitness journal to stay accountable.

18. Put your workouts on your calendar. you’ll be more likely to do them.

19. Choose skim, soy, almond, or rice milk over full fat milk and cream.

20. Move more– take the stairs, do squats while you’re watching TV, stand at your desk, do toe raises while you brush your teeth.

21. Plan active outdoor activities instead of watching TV or seeing a movie.

22. Skip the sugar in your coffee or cereal.

23. Snack smart– choose fruit, low fat yogurt, nuts, or veggies and hummus to stay satisfied.

24. Take a walk after dinner.

25. Order salad dressing on the side and add a little bit on your fork when you want some flavor.

26. Chew minty gum to ward off cravings.

27. If you go out to dinner, choose a cocktail or dessert, but not both.

28. Get at least 7 hours of sleep. Being tired makes you more likely to eat more.

29. Flavor your food with spices and herbs instead of salt and sugar.

30. Bring your own lunch. You’ll know exactly what’s in it!

31. Join a weight loss group for extra support! Try, Lose 10 Pounds



8 Healthy Habits for Weight Loss

Losing weight is not just about dieting. More important are making lifestyle changes that can be helpful for losing weight and keeping the weight off. Here are some simple strategies.

Losing weight and keeping it off is a matter of cutting back what you eat and increasing your amount of exercise. “The simplest equation in the world, calories in and calories out, determines your weight loss,” says Christine Gerbstadt, MD, RD, of Sarasota, Fla., spokesperson for the American Dietetic Association.

But if that’s all you do, you may find yourself ultimately regaining the weight you worked so hard to lose. The reason: Weight loss is a matter of lifestyle and, if you don’t adopt the healthy habits necessary to sustain your weight loss, you could backslide into overweight and obesity.

Here are some tips aimed at helping you create a healthy lifestyle that will improve your chances for successful weight loss. They might seem like common sense, but many people committed to losing weight neglect these healthy habits and end up struggling to succeed.

1. Watch Your Portions

Portion control is a key challenge to Americans pursuing weight loss. “The best way to control the calories is to go with portion control,” says Dr. Gerbstadt. Piling food onto your plate can make you feel pressured to eat it all. Start with small portions, and go back for (a little) more if you’re still hungry. Keep in mind that your stomach will grumble early on, until it has shrunk to adapt to the smaller meals you’re now eating.

Portion control is doubly important when eating out. “Most people are catching on to the fact that when you eat out at a restaurant, the calories are two to three times what you really need for that meal,” says Gerbstadt. “You might get a salad and an appetizer and call it a meal, rather than get a salad and an entrée.”

2. Eat Slowly

It takes a little while for your body to realize that you’ve eaten and to stop sending signals of hunger. If you slow down and savor your food, you probably will eat less before your body acknowledges that you’re full.

3. Eat Your Vegetables First

Vegetables contain plenty of fiber and bulk but few calories. By eating them first, you might eat less of any fatty or high-calorie items on your plate.

4. Don’t Skip Meals

Skipping meals sounds like a good idea, but it actually undermines your weight-loss plan. Your body thinks it is being starved and starts building body fat in an attempt to store energy away for later. On top of that, you’re likely to be even hungrier for your next meal and eat far more than you would have otherwise. The best course is to eat three small meals, with two or three small snacks in between.

5. Drink Plenty of Water

Water helps you feel full throughout your day, aiding your weight-loss efforts. Water also provides innumerable health benefits to your skin and your digestive and circulatory systems.

6. Switch to Healthy Snacks

Swap out the high-calorie or high-fat snacks in your diet for healthier alternatives. Fruits, low-fat string cheese, peanut butter, and whole-grain crackers are some good options. Create snacks that combine carbohydrates and proteins, like peanut butter on apple slices, as they will make you feel full longer.

7. Exercise as Often as You Can

Burning calories through physical activity is essential to weight loss. If you don’t burn more calories than you eat, you won’t lose weight. “People think they’re too busy to walk 20 minutes a day or do a little weight training or ride a bike, and then they wonder why they can’t lose weight,” Gerbstadt says. “If you try to diet without exercise, it just takes that much more effort.” Any physical activity, even long walks, will help.

8. Keep a Record

Food diaries are a proven aid to people pursing weight loss. Keep track of what you’ve eaten and how many calories the food contained. If you also keep a record of your exercise, you can compare how many calories you’re burning to how many calories you’re consuming.

Healthy and sustainable weight loss does not occur overnight, despite the promises of fad diets. Losing a pound or two a week is normal, and shows that you are adopting weight-loss habits as a part of your lifestyle.

Last Updated: 08/04/2009


Can Eating Too Few Calories Stall Your Metabolism?

Learn why cutting out too many calories can keep you from losing weight.


“It would make sense to stop eating [when you are trying to lose weight], but it actually works in the opposite way,” says Kimberly Lummus, MS, RD, Texas Dietetic Association media representative and public relations coordinator at the Austin Dietetic Association in Austin, Texas.

Calories and Your Health

The most effective way to lose weight is to consume fewer calories than you expend, creating a calorie deficit. But if your calorie intake dips too low, says Lummus, your body could go into starvation mode. “Your body will start to store fat because it thinks it is not going to get anything,” says Lummus. “You will be at a point where your body is kind of at a standstill.”

Lummus says that when your body goes into starvation mode, your metabolism slows to a crawl, burning calories as slowly as possible to conserve its energy stores. This is why people who cut their calories too much may reach a plateau and stop losing weight.

Eating too few calories can be the start of a vicious cycle that causes diet distress. When you cut your calories so low that your metabolism slows and you stop losing weight, you probably will become frustrated that your efforts are not paying off. This can lead you to overeat and ultimately gain weight.

“It is so hard to sustain cutting calories and eating too little. What typically happens is that the person will go in the opposite direction; they will just become too hungry and go into a binging mode,” says Lummus. “Because you are getting frustrated by not seeing any weight loss, you just sort of throw in the towel.”

In addition to sabotaging your weight-loss efforts, eating too few calories can also harm your health. When your body goes into starvation mode, you are at increased risk for the following:

  • Abnormally low blood pressure and slow heart rate
  • Heart rhythm abnormalities
  • Electrolyte imbalances, especially potassium deficiency
  • Gallstones
  • Hair loss
  • Brittle fingernails
  • Loss of menstrual periods in women
  • Soft hair growth over entire body
  • Dizziness
  • Trouble concentrating
  • Anemia
  • Swelling in your joints
  • Brittle bones
  • Depression

Coming to Terms With Calories

Remember that calories are not your enemy. They are a vital part of a healthy and energetic life. “Your body needs a certain amount of calories just to sustain proper function,” says Lummus. This is why fad diets that force you to cut out too many calories leave you feeling lethargic, shaky, and ready to give up.

Instead of opting for a fad diet, find a reasonable eating and exercise plan that allows you to lose one-half to two pounds per week. There is evidence that people who lose weight at this rate — by making better nutrition choices, eating smaller portion sizes, and exercising — also have the best chance of keeping it off. Make a plan to adopt new healthful habits that you will be able to stick to indefinitely, and always allow yourself a little wiggle room for special occasions.

Last Updated: 04/03/2009


Counting Calories Isn’t Enough—You Need to Factor in Appetite and Metabolism

Metabolism determines how efficiently we’re burning calories and appetite determines how satisfied they make us. There are ways to increase the former and decrease the latter, which will make it a lot easier to maintain a healthy weight.


Sanjay Gupta, MD, Everyday Health:
When it comes to maintaining your weight and staying fit, you want to look at how many calories you’re taking in every day and also how many calories you’re burning off. It sounds simple, right? But it’s a lot harder than simple addition and subtraction.

If you look at restaurants, they’ll post calorie counts. That can help. There are apps out there that will help you do that as well. There are also devices that will look at how many calories you’re burning throughout the day, like the FitBit, for example.

But it’s actually a lot more complicated than simply looking at those calories. There are two big influencers that affect that — metabolism looks at how efficiently you’re burning those calories throughout the day, and also your appetite, which looks at how satisfied those calories are making you.

So there’s the goal — you want to increase your metabolism, decrease your appetite, and I’m going to give you some tips on how to do so. And I promise you, some of these are not that obvious.

For example, don’t be tempted to skip breakfast. Sure, you’ve cut some calories, but you’ve also cut your metabolism.

Kristin Kirkpatrick, RD, Cleveland Clinic:
After a night’s sleep when your body is burning calories and working hard to keep you alive while you sleep, you need to fuel it the next day. You need to break that fast.

Dr. Gupta:
Skip breakfast, and your body can go into a sort of starvation mode.

Kristin Kirkpatrick:
Your body essentially says, OK I don’t have the fuel I need to function, so I’m going to have to lower the metabolism a little bit to survive.

Dr. Gupta:
Lower metabolism means your next meal will not be burned off as fast. And what you eat for breakfast is also important, especially when it comes to that other factor — appetite. Try to start the day with protein — things like yogurt, eggs, or egg whites if you want to avoid cholesterol. Protein will make you feel full longer.

So what about sweets? Not all sugars are created equal. Researchers at Yale compared the two simple sugars that make up table sugar, also known as sucrose. They are glucose and fructose. Now, fructose is also found in fruit, but we’re getting a lot more of it these days in high-fructose corn syrup as well as processed foods.

The researchers found that fructose is not as good as glucose at making us feel full. So when foods are sweetened with high-fructose corn syrup as opposed to sugar, we may tend to eat more of them. There is some evidence that even artificial sweeteners with no calories at all may still boost the appetite, and contribute to weight gain indirectly.

When it comes to carbs, the harder they are to digest the better. That boosts metabolism. So whole wheat is better than white, and beans may be the best of all.

Kristin Kirkpatrick:
Beans have something called resistant starch, which is starch that is a little more difficult for our body to digest. The more difficult it is for our body to digest something, the more energy it’s going to take to actually do that.

Dr. Gupta:
Finally, adding spice to your life may also boost your metabolism. There is some evidence that a chemical in black pepper prevents fat cells from forming.

Reduce your appetite, increase your metabolism, and you’ll find keeping that nutritional balance is a lot easier.

With Everyday Health, I’m Dr. Sanjay Gupta. Be well.

Last Updated: 11/14/2013

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