Transcription:
Intermittent Fasting

Melanie Cole (Host):  Welcome to Stoughton Health Talk. I’m Melanie Cole and today, I invite you to listen in as we discuss intermittent fasting. Joining me is Autumn Kumlien. She’s a Registered Dietician Nutritionist, Clinical Dietician and F&S Nutrition Coordinator at Stoughton Hospital. Autumn, I’m so glad to have you join us again today. Great guest as always. I’d like you to start because this is such a good topic, by helping us to understand the effects of intermittent fasting, of fasting really, on our body. How does that work?

Autumn Kumlien, RDN, CD (Guest):  Intermittent fasting is a really hot topic right now as you mentioned. And what health effects on your body is for prevention of many diseases including Alzheimer’s, dementia, autoimmune conditions, rheumatoid arthritis, lupus, looking at also not only as I mentioned the brain health, but body health. Autophagy is a process that happens when you intermittent fast and during the fasting process, it’s when your body is basically recycling older damaged cells and making new better building blocks. So, it’s like an upcycling system that’s happening in your body. And so, it’s a wonderful thing that’s happening.

So, it is definitely not just for weightloss, but the health benefits that are associated with them.

Host:  So then tell us how it works. How does intermittent fasting work? What’s the science behind it? tell us really, how it works and how do we know?

Autumn:  Intermittent fasting is more about a pattern of eating. So, we know our ancestors, they did not have food in every corner or able to eat every single day so you’d hunt for your food and you’d fine your food and there may be days in which you didn’t eat. So, in those times in which you didn’t eat, your body utilized your fat stores to break down as energy to fuel your brain and your body. And during that process, when it breaks down your fat stores, it creates ketones. And ketones is an energy source that your body thrives on. Your brain thrives on it. So, by giving your body the chance to fast, we are allowing our body to do what it was naturally designed to do. We are allowing it to tap into our fat stores to utilize the stored energy that we have on board instead of getting that hunger signal or eating because it's time. And we eat a meal or eat a snack and then our body burns that because it has no need to break into our energy stores when we constantly have fuel coming in.

So, intermittent fasting allows us to tap into those stores so that if we have weight issues, we can break those down and lose weight and make it more continued and life sustainable. And also, a lifestyle pattern. We are able to ward off many health conditions and diseases and correct many things. people report improvements in their vision, improvements is scars. One of the greatest things with intermittent fasting is the use for type 2 diabetics. We’ve always been told that type 2 diabetes is progressive chronic condition that will worsen as the disease progresses. And that you just take your medication, your insulin and we try to treat the symptoms. However, we know now, based on the research studies that have been done and people’s reports that when people adapt an intermittent fasting lifestyle, they are able to go off of insulin, they are able to lower their fasting insulin [should be glucose 00:03:25] levels, they are able to lose the weight, they are able to in some cases, be termed, not diabetic anymore. So, there’s amazing health benefits associated with it and why you would want to intermittent fast.

Host:  Thank you for that and there are a lot of benefits. Are there any side effects you’d like us to know about? Does it cause muscle loss? Can it slow down metabolism or affect bone density? Tell us a little bit about any side effects that people might notice.

Autumn:  Absolutely. There is no side effects that I could mention. The only thing is that it’s not recommended for somebody that has an eating disorder or somebody that is a growing child. There’s ways of doing it safely but not something right off the bat that they would want to restrict in that way or females who are pregnant. That’s contraindications of when you would not want to do intermittent fasting. However, there is really no negative side effects to it. It will maintain your lean muscle mass because fasting increases human growth hormone and human growth hormone allows you to build muscle and maintain your lean muscle even while fasting and not doing any scheduled or formal weight lifting program just by doing your activities of daily living like picking up your children or your grandchild or carrying the groceries in the house. You will maintain and even easier to gain muscle mass.

I mentioned the health benefits associated with it. It helps you to start getting back in touch with your satiety signals and your ques and your hunger and your hormones as well. So, you are listening to them better and you’re stopping when you are full and you’re not eating when you’re just maybe bored or thirsty. So, there’s a lot of benefits that way. But there’s truly no negative benefits to it. It’s a lifestyle that you can adapt and continue throughout your entire life which is the amazing part of it having the health benefits associated with it. Many people, they come for the weightloss, but they stay for the health benefits. So, that’s the fun side of it and I personally have done it. I continue to do it. My husband does it. he is a type 2 diabetic. My mother-in-law insulin resistance, same thing. All of them having wonderful success and it’s definitely become a lifestyle.

Host:  Well then tell us how to do it. How does someone get started. For myself, personally, I’ve wanted to try it for so long, but I feel like I would just be so hungry, and I would just not be able to stick to it. Tell us how to get started. What do we do? What liquids can we drink? What foods can we eat? Tell us how to do it Autumn.

Autumn:  The easiest thing is to keep in mind, many people wonder why have we not known about this or why are we not promoting it more and it’s because there’s no money in it. You’re basically telling people not to eat. Don’t eat as much. So, it is money saving and the way to utilize it or to start intermittent fasting is to start out with a pattern for an example, and 18-6 or 16-8. Those are probably the easiest to start with. So, what that means is you would intermittent fast or you would fast 16 to 18 hours a day and then you would eat anywhere in a 6-8 hour eating window. So, that might sound like a lot but you’re taking into account your evening meal, not snacking after dinner and you take into account the hours in which you sleep and then it might be as simple as skipping breakfast. And I know we’ve always been told breakfast is the most important meal of the day and unfortunately, that was a study that was paid for and put out by Kellogg’s. So, we want people to eat breakfast based upon getting certain grains in cereals purchased but that’s not how our bodies were designed.

And so, for some, it’s as simple as not eating after dinner, counting those hours of sleep and skipping breakfast and opening up your window late afternoon to mid-day, eating in a six to eight hour window and then repeating the process the next day. And some people can even do tighter windows, can fast for 20 hours and eat only they call it one meal a day or an OMAD and some people thrive on that as well. That’s the pattern I prefer but everybody’s different. There’s even patterns that are promoted by Dr. Jason Fung. He’s a nephrologist out of Toronto Canada. And he has written many great books like Obesity Code, Diabetes Code and he does more of an alternate day fasting. So, he has his patients eat unrestricted for one day and the next day, they intermittent fast and basically would fast a whole day or maybe only take in a 500 calorie meal as a dinner option and then they would repeat the pattern every day.

So the key behind making it work is called the Clean Fast. And Jen Stevens, author for many great books Delay Don’t Deny, Fast Feast Repeat her newest book, she talks a lot about the Clean Fast and the benefit behind that is that you are only consuming beverages in which will not elicit an in insulin response because that’s the problem. We have high levels of insulin that are floating around in our blood stream continuously all day every time we are sipping on some sweetened beverage or snacking multiple times a day. So, the goal is when we’re not eating, to keep our insulin levels low, so we can enjoy black coffee, no creamer, black tea, no sugar, no nonnutritive sweeteners at all, water obviously, unflavored carbonated beverages are fine but those all fit into a clean fast because when we take in things that have artificial sweeteners in them, or creamer, our body still sends it’s signal to our brain that’s a sweet taste and it gets the digestive processes going and it kicks you out of your fasting and makes it much harder to make it through your fasting.

You can experience white knuckling where you feel like you are ravenously hungry. Contrary to what most people believe, you’d think that well if you’re not eating you would just be starving. And as you work up your fasting muscle, the longer you do it, the more you do it, you actually find your hunger decreases. So, if you’re doing an extended fast, it’s going beyond 20 hours; you’re doing a 36 hour fast for example, you find that as the hours go on, you become less and less hungry.

Host:  Wow, that was a great description. So, does the timing of when you eat, you’ve mentioned these numbers, so if you’re doing like an 18 hour fast, or something along those lines; then when you do choose to eat, is nighttime better? Is daytime – does that even matter when those 18 hours are?

Autumn:  No, right now, there isn’t any research looking at comparing people that have a morning eating versus afternoon versus an evening window. That will be some great information if they do some research on that. But right now, there’s only some looking at Circadian rhythm and some finding that you should eat more with the rising of the sun and how your body’s waking up and doing that. But people’s success is all dependent upon what pattern works for you. And you typically like to eat at night, for me, I work all day, I’m very busy, it’s easy for me not to eat at work. But then I want to come home and have dinner with my family. So, it’s very important to me. So, having an evening eating window for myself works the best. Some other people they really like that almost normal eating pattern so they might open up at noon and close it by six, they might have kind of a mid-day window. Some people really thrive on eat breakfast early in the morning and then closing it up about noon or one o’clock. So, it all depends on what your preference is and what feels the best to you.

So, it’s all when you’re willing to, you can make it a lifestyle and you can continue it because it’s not a fad diet. It’s not something you start and stop. It is something that once you decide you’re going to do it, you will find that you feel so amazing when you do it and you have brain clarity, you don’t have the confusion, you are like at the top of your game, you are very focused, that you want to keep doing it. It’s a wonderful feeling and as I mentioned, the health benefits that are associated with that.

Host:  So, before we wrap up, I still have a few questions because this is such an interesting topic. Can you exercise during the fasting period.

Autumn:  Absolutely. And actually, they’ve done studies looking at people that only eat in nine hour windows and found that they were tracking their energy the next day. So, if they were fasting overnight, and they were only eating in a nine hour window, they would wake up in the fasted state, and exercise and they would find that their markers of energy were significantly higher than had they eaten breakfast before they exercised. So, absolutely. People have run marathons fasting so it’s nothing to be scared of. But obviously, you do have to listen to your body. If you find that you’re nauseous or you’re not feeling good, then maybe you are a person that would need to either exercise within your eating window or right before you start your fasting or alternate that way and find a pattern that fits better for you. But yes, you can exercise but it’s not required. We have found – we always talked about calories in, calories out, eat less, move more. But that isn’t always the case. And we know many people are very good about exercising and they’re very good about making the right food choices but yet, they still have a lot of weight and they can’t lose it and it just hangs on and we find as we get older and older, it’s harder and harder to lose that weight.

So, exercise is more for the health benefits. Exercise because it’s good for your body and it’s good cardiovascular wise but, in terms of exercising a ton to help you lose a whole bunch of weight; that just doesn’t seem to be truth in that.

Host:  And my last question, is how long? You’ve been talking about the benefits and as a lifestyle how long does it take you to notice those results? Is one fast, will you feel better after one 18 hour fast and see more clearly and feel more energy or is there the fatigue and mental fog that goes with it and then you eat, and you feel better and then you try it again the next day? How does all of that work? And then please wrap it up with your best advice about people that have questions about intermittent fasting.

Autumn:  It all depends on what feels good to you. Obviously, everybody is different. But you should definitely, if you are going to try it, start out nice and easy. Maybe do a 12-12 so only fast for 12 hours and eat in a 12 hour window. And when those become habits and easier, then you can start fasting an hour longer and make it more incremental. Some people just rip the Band-Aid off and they dive right in. So, it all kind of depends on the individual. If you notice that you’re getting lightheaded or you’re just not feeling good and you drink water and things don’t seem to get better; you’ve waited 20 minutes; you got to listen to your body. And if you body is telling you now is the time to eat, now is the time to eat, and you try again the next day.

I’ve heard both ways. Some people do say initially it’s difficult, I did it very slow and transitioned. I didn’t have any problems for myself. I noticed within the first 24 hours; bloating had decreased just feeling lighter. There’s a process as I mentioned, the autophagy that happens but also when you are losing weight, there’s body recompositing that happens so your scale might not be moving, but you’re becoming smaller. You’re losing fat in places that other diets and other things you’ve done have never tapped into. So, you will start feeling slender fairly quickly. And depending on what protocol you do, as I mentioned, if you do a alternate day fasting; because of the up down day effect, those are very successful for many people especially for people that want to hit it hard and really see something right away. Those are very effective with that.

And if you want to do more of a slower approach, and pick more of an eating window, as more of what I do. But for anybody that tries it, you’re going to notice something and even if you say the scale’s not moving but I feel fantastic, then it’s working. There’s some benefit that you are getting from it so keep trusting the process and keep following forward. So, what I would like people that are interested in intermittent fasting and please do and we’re hoping to get it recorded. We did offer the class a couple of times via Zoom but getting a recording up on the Stoughton Health Website so be looking for that. Also I cannot recommend enough to read the book Delay Don’t Deny, Feast Fast Repeat by Jen Stevens. Reading Obesity Code and Diabetes Code by Dr. Jason Fung, those will give you the premise, the research, the data. There was an article December of 2019 in the New England Journal of Medicine looking at autophagy.

So, putting intermittent fasting on the map, what practitioners can use to follow for protocols to get their patients intermittent fasting. So, it’s something we’re going to hear more and more about and the wonderful thing about it is that there is no special diet foods or anything, pills or potions or anything that you have to buy or utilize. If you are a person that does really well and you want to do a keto diet, well you can intermittent fast and keto diet. If you are a person that doesn’t eat gluten, well you can be gluten free and do an intermittent fasting diet. If you’re vegetarian, if you’re vegan, it doesn’t matter what your food choices are, as a dietician, obviously I’m going to encourage healthy food choices most often, whole grains, fruits and vegetables, good variety but it’s not dependent necessarily in the big picture on everything that you’re eating, it’s more about your timing. And once you get the timing and the fast done, you’ll find that your body craves, and you want things that are healthier.

You want things as we call window worthy. You want them to be worth it. If you’re fasting for such a period of time, you don’t want to fill your body full of junk and high processed food; you want to give yourself some really good nutrition. Try it, trust the process, join some Facebook groups that involve it, read the books, do the research for yourself because with the data that’s coming out now, it’s hard to deny that this is an amazing revolution that’s happening right now.

Host:  Wow, what great information. We can use this information right now Autumn and you are a really very informative guest. Thank you so much and for more information you can call 608-873-2332 to get connected with one of our providers or you can visit our website at www.stoughtonhealth.com. That concludes this episode of Stoughton Health Talk. Please remember to subscribe, rate and review this podcast and all the other Stoughton Hospital podcasts. Share this show with your friends and family on social media because not only are we learning from the experts together from Stoughton Hospital, but this is really great information and so informative. This is Melanie Cole. Thanks so much for listening.