At the June International Conference for Functional Medicine in Florida, Dr. Jeffrey Bland, a pioneer and founder of the field of Functional Medicine declared that if any of us are not routinely fasting for a minimum of 12 hours a day, and not recommending that our patients do the same, that we are missing out on one of the most fundamentally important therapeutic strategies for supporting optimal health. Fasting increases stem cell regeneration and enhances the immune system.
It is the norm in our culture to regularly eat three meals a day and very common to snack in between. This feeding schedule requires the pancreas to steadily secrete the fat storage hormone insulin in order to regulate blood glucose which is repeatedly elevated by the food that we eat. Our practice of constant feeding results in high insulin levels and paradoxically a resulting decreased insulin sensitivity. More and more insulin is required to move the glucose out of our blood stream and into our cells. This condition is called insulin resistance. Insulin resistance is a precursor to diabetes and is associated with obesity, as weight gain is mediated by insulin levels.
There is a strong correlation between insulin levels and the degree of inflammation in the body. The higher the level of insulin, the greater the degree of inflammation. Inflammation is the mediator of chronic disease states. Cardiovascular disease, cancer, diabetes, auto immune diseases, neurodegenerative diseases to name just a few, are all fueled by inflammation. Inflammation is also associated with depression, anxiety, attentional difficulties and brain fog and other psychiatric symptoms. It is directly linked with aging.
I recommend that my patient’s fast for a minimum of twelve hours a day, and if possible, to extend that interval. The narrower the window of eating the greater the health benefits. Many patients initially respond that they could NEVER do that, that they would experience hypoglycemia and would not feel well if they did not eat. The biggest obstacle to implementing this practice seems to be psychological. People are terrified at the thought of skipping meals. For most it is very possible over time, to gradually extend the window of fasting. I suggest to them that they extend the fasting interval by half hour increments. Many now eat between 3 in the afternoon until 8 at night.
It does not matter when you fast in terms of accruing fasting’s health benefits, though our natural hormonal circadian rhythm makes it easier for most to skip breakfast. In the morning the hunger hormone ghrelin seems to be naturally at the lowest point. It’s important to adapt your fasting schedule to your life style and to implement it in a way that works for you. Many people eat dinner together with others, so it would be best to not fast at that time. It is also important to be flexible and if there is a special occasion to participate and to put fasting aside for the day and to fully enjoy the celebration. The intermittent fasting routine can be quickly resumed afterwards. In other words, intermittent fasting is the routine habitual long term plan with exceptions made so that one may fully participate in special occasions.
In my clinical and personal experience, this practice is a magic formula for weight loss. I have a number of patients in my practice who have lost significant amounts of weight using this strategy and feel so much better. Excess weight has steadily dropped from those who previously had difficulty shedding pounds and their feeling of well being, alertness and energy has exponentially increased. Many report that once that they get used to it, that its really so much easier than trying to lose weight by controlling portion size. Though they may be very hungry when they do finally eat, they discover that they feel full much more quickly. They are finding that they are eating much less at dinner than they previously did when they were eating three meals a day plus snacks. This reduced intake is not imposed or a result of deliberate restriction but is organic. They are just not as hungry.
The book that is pictured at the beginning of the post “The Complete Guide to Fasting” is by a nephrologist, Jason Fung, MD who successfully treats Type 2 Diabetes and obesity with intensive dietary management and Jimmy Moore, a lay person who has been instrumental in popularizing low carb diets. It’s an excellent accessible book. Be sure to read the many reviews of the book on Amazon which bear witness to the fact that intermittent fasting is the only weight loss approach that has ever worked for them and that has been sustainable.
The authors have found that many people are still able to reap the benefits of intermittent fasting when they include drinking broth during the fasting intervals. The inclusion of broth makes fasting even easier. The book also includes information of the considerable health benefits of extended periods of fasting, but I have not yet explored this personally or in my practice.
Here is a page of questions and answers by Dr. Fung regarding intermittent fasting.
Here are a couple of fascinating interviews about the therapeutic benefits of fasting.
do you think it’s safe to do the full 25hour yom kipur dry fast?
Dr. Tsafrir says
If you are in good health, I believe it is safe. If you are not, then it probably would not be as well tolerated.
Dr. Tsafrir – I have experienced the benefits of intermittent fasting you describe, though I do it only occasionally. I may try doing it every day, and skipping breakfast would make sense for me. However, I’m not willing to skip coffee. Do you know how caffeine during the fasting period affects the results?
Dr. Tsafrir says
Coffee and tea and other non calorie beverages do not interfere, though artificial sweeteners should be avoided. Caffeine seems to be fine.
Great topic! My particular bio system is sensitive and so too much caffeine can disrupt my blood sugar balance (and I’m already AIP Paleo), so the caveat may be to pay attention in case the caffeine stimulates you to want to eat; then you’d need to reduce it a little. In a perfect scenario, maybe none of use would use it.
Afifah Hamilton says
But I thought that AIP Paleo kept all beans out and coffee is bean based. That might be a disrupter for a variety of reasons.
Dr. Tsafrir says
I believe that you misunderstand. This is a post about Intermittent Fasting, not about the Paleo AIP. This is a strategy for timing of meals, not about what you are eating when you do eat. But to address the question you raise: my understanding is that coffee is excluded in the elimination phase of the Paleo AIP because some people experience coffee as cross reactive with gluten, not because it is a legume. I hope that this clarifies.