Features August 2017 Issue

Is Intermittent Fasting Right For You?

The word fasting may sound extreme, but this dietary approach is not about starving.

OverweightJointPain

© Eraxion| Dreamstime.com; NIH

For people who are overweight and have arthritis, dropping even a few pounds can help relieve pain. The more weight you can shed and the closer you get to normal, the less stress you put on your joints and the greater the pain relief. A normal body mass index (BMI) is 18.5 to 24.9.

The reality is that over two-thirds of adults in the United States are not normal weight. They are overweight or obese. If you fall into these categories, no one needs to tell you how difficult it is to lose weight. Most weight loss programs require willpower.

“Willpower means taking something you love, like a chocolate chip cookie, and saying I can no longer have it,” says Cleveland Clinic dietitian Kristin Kirkpatrick, RD, LD. “You want the cookie, and you have to will yourself not to have it.”

A Better Way

A better weight loss plan would take away the craving. That’s the potential of an intermittent fasting diet. Intermittent fasting does not mean completely going without food. “This is not a starvation diet,” says Kirkpatrick. The idea is to strategically time eating so you cycle through periods of normal eating and ingesting no or minimal calories.

While it might seem that restricting calories would make you very hungry, Kirkpatrick says that it’s the opposite. “Hunger actually goes down.” Your body adjusts and you are satisfied with smaller amounts of food. “You see the chocolate chip cookie, but you don’t have to have it.”

A patient of Kirkpatrick’s who just started a fasting plan noticed that she felt some hunger in the evening. She expected to be starving the next morning, but she actually had little appetite when she woke up.

BMI App

© Sementsovalesa | Dreamstime.com; NIH

Body mass index (BMI) is a measure of body fat based on height and weight.

18.5 to 24.9..........Normal weight

25 to 29.9...............Overweight

30 +.........................Obesity

40+......................Morbid obesity

To calculate your BMI, go to this NIH web site:

http://bit.ly/1D0ZqDv

Or you can download the NIH BMI calculator app.

Evidence

A growing body of evidence shows that different forms of fasting can lead to weight loss and promote good health. It’s been shown in both animal and human studies that restricting calories increases lifespan.

A study published in the journal Cell Metabolism (February 2014) reviewed the evidence on how intermittent fasting affects cells and hormones in ways that improve health and reduce risk for chronic diseases. A study published in the Scandinavian Journal of Rheumatology (2001) found that intermittent fasting followed by a vegetarian diet reduced pain and inflammation for people with rheumatoid arthritis.

Getting Started

There are different approaches to fasting. For people just getting started, Kirkpatrick recommends baby steps. She usually has her patients start with time-restricted feeding.

With this approach, you restrict all eating to within a certain time window. For example, you consume all calories before 5 p.m. This way you’re fasting for about 14 hours before breakfast the next day. You can also choose a different time window. Some people skip breakfast and eat all calories during a six-hour period in the afternoon and early evening.

“For most people, this overnight fasting is easy to do,” says Kirkpatrick. “Many people stick with it and lose weight.” Others graduate to the popular 5:2 plan.

5:2 Diet

With the 5:2 diet, you eat normally on five days of the week and restrict calories to just 500 (for women) or 600 (for men) on two days of the week. These calories are split between breakfast and dinner.

On the two fasting days, Kirkpatrick recommends eating foods high in protein and fiber. “You don’t want to eat breakfast cereal because you’ll be way too hungry,” she says. Instead, try toasted sprouted grain bread, which has extra fiber and protein. She also suggests limiting fats on fasting days because fat has nine calories per gram, which is a lot of calories.

Egg Frittata

© Terivirbickis | Dreamstime.com

“I will tell you that about 70 percent of my patients cheat at around 3:30 or 4 p.m.,” says Kirkpatrick. But they are still able to lose weight.

5:2 Intermittent Fasting Diet Meal Suggestions

Sample meals are 200 to 300 calories

Salmon

© Littledesire | Dreamstime.com

Breakfast Options:
- Egg, extra egg whites, and one slice of toasted sprouted bread
- Omelet or frittata with mushrooms, spinach and bell pepper plus one slice of toasted sprouted bread
- Nonfat Greek yogurt with berries and almonds
- Oatmeal (1 cup) with ½ banana
- Protein shake (made from plant-based protein powder, unsweetened almond milk and ice)

Greens

© Elenathewise | Dreamstime.com

Dinner Options:
- Black bean pasta (2 oz) with spinach, mushrooms, bell pepper, zucchini and tomato sauce
- Chicken (4 oz), spaghetti squash with tomato sauce, broccoli, cauliflower
- Salmon (4 oz) with ½ cup quinoa and spinach

Foods With Little Or No Calories:
- Leafy greens, such as spinach, mustard greens, kale, chard
- Water
- Coffee

Other Approaches

Kirkpatrick finds that the time-restricted feeding and 5:2 intermittent fasting approaches are most effective for weight loss. But there are other options.

You might try a monthly approach. Eat normally on most days of the month, but on five consecutive days cut calorie intake by 35 to 50 percent of normal. These calories should be 10 percent protein, 40 percent carbohydrates and 50 percent fat. Another approach is an alternate day fast.

Talk to a nutritionist about your goals to identify the plan that’s right for you.

What You Eat Matters

Intermittent fasting is essentially about number of calories and when you eat them. But what you eat still matters. Make sure you choose whole, fresh foods on both fasting and nonfasting days.

You still need to follow a sound eating pattern, including healthy fats, whole grains, fruits and vegetables and lean sources of protein. “It’s not about going hog wild on nonfasting days,” says Kirkpatrick.

It’s also important to stay hydrated. So be sure to drink enough liquids (mostly water, herbal tea or coffee). Stay away from sweetened beverages, which only increase hunger.

Adequate sleep is also necessary for good health and weight loss. Try to stick to a regular schedule of going to bed and getting up at about the same time.

Talk to Your Doctor First

Talk to your doctor before starting a fasting diet. Some people should not try intermittent fasting. For example, people with diabetes who are taking medication, women who are pregnant or breastfeeding, children, people with a history of an eating disorder and people recovering from surgery should not go on a fasting diet.

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