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Intermittent Fasting: A Healthy Choice

Posted: 06/06/2012 8:46 am

The advice to have five or six small meals daily has become common in recent years. I am 69 years old and don't recall ever hearing this as a child and seldom as a young adult, but by the 1980s it seemed to be everywhere. Today, it is close to nutritional dogma. It is not surprising that an online search of the phrase "eat many small meals" returns over 275,000 results.

The usual justification for eating extra meals is that it keeps the metabolism "revved up" so that weight loss is easier. There is, however, very little hard evidence that supports this idea, and a fair amount that disputes it. For example, a research analysis published in the British Journal of Nutrition concluded that "any effects of meal pattern on the regulation of body weight" appear to be negligible, and what matters is total food intake.

Worse, the "eat many small meals" advice has two clearly negative effects:

  • In practice, those extra meals usually aren't vegetable-intensive, home-cooked ones. These days, they are likely to be "energy bars" (a euphemism for candy bars), snack mixes, and so on. In other words, high-glycemic-load processed snacks.
  • When people are told to "eat many small meals," what they may actually hear is "eat all the time," making them likely to respond with some degree of compulsive overeating. It's no coincidence, I think, that obesity rates began rising rapidly in the 1980s more or less in tandem with this widespread endorsement of more frequent meals. (The other major culprit was the government's scientifically shaky "low-fat" dietary recommendation that led to rampant overconsumption of carbohydrates.) In my travels around the world, I am often struck by how rarely I see people eating in their cars, or while strolling down the street, or otherwise outside the traditional time and space boundaries of a meal. In the U.S., these behaviors are ubiquitous.

So the time has come to explore the opposite idea: regularly allowing greater-than-normal amounts of time to pass between meals, a practice known as "intermittent fasting," or IF. Frankly, today in America, simply eating three meals with no snacks might be called a form of IF, if only by way of contrast. If we were to return to this once-common practice, I believe we would be healthier for it.

The basic premise of IF is to enjoy better health via repeatedly fasting for longer periods than is typical on a daily breakfast-lunch-dinner schedule. Variations are endless. Some proponents skip breakfast; others, dinner. Others fast all day every other day, every third day, once per week, or once per month. A friend I know who travels for work six to eight times annually always fasts on the first and last days of his trips, reasoning that airline food is awful anyway. (Fasting, it should be pointed out, means abstaining from solid food; all sensible IF plans allow hydration with water, tea or other no- or low-calorie beverages.)

An IF regime works, proponents say, because it aligns with our evolutionary history. Over the 250,000 years that Homo sapiens have been around, food supply has waxed and waned. We evolved to take advantage of this fact, building muscle and fatty tissue during times of abundance, then paring it back during lean ones. Fasting periods accelerate the clearing-out of waste left by dead and damaged cells, a process known as autophagy. A failure of autophagy to keep up with accumulated cellular debris is believed by many scientists to be one of the major causes of the chronic diseases associated with aging.

Occasional fasting also seems to boost activity and growth of certain types of cells, especially neurons. This may seem odd, but consider it from an evolutionary perspective -- when food is scarce, natural selection would favor those whose memories ("Where have we found food before?") and cognition ("How can we get it again?") became sharper.

Research indicates that the benefits of IF may be similar to those of caloric restriction (CR) in which there are regular meals, but portions are smaller than normal. The advantage of IF, proponents say, is that it's easier to feel sharp hunger occasionally rather than the mild hunger of CR virtually all the time.

The positive effects of IF have been chronicled in a variety of animal and human studies, starting with a seminal experiment in 1946, when University of Chicago researchers discovered that denying food every third day boosted rats' lifespans by 20 percent in males, 15 percent in females. A 2007 review by University of California, Berkeley, researchers concluded that alternate-day fasting may:

  • Decrease cardiovascular disease risk.
  • Decrease cancer risk.
  • Lower diabetes risk (at least in animals, data on humans were less clear, possibly because the trial periods in the studies were not long enough to show an effect).
  • Improve cognitive function.
  • Protect against some effects of Alzheimer's and Parkinson's diseases.

What should we make of this?

I don't recommend IF for everyone. Children under 18 should not fast, nor should diabetics, nor pregnant or lactating women. Some health conditions -- such as severe gastrointestinal reflux disease, or GERD -- are easier to manage when food intake is more regular.

But I do think the evidence for the health benefits of IF should make us rethink what seems to be a modern cultural imperative: to avoid hunger at all costs. To the contrary, getting hungry now and then is clearly a healthy thing to do as long as overall caloric intake stays high enough to maintain a healthy weight. (Fasting, like every other healthy activity, must be done sensibly and in moderation.) Many people who follow IF regimes report both physical and mental benefits, including improved energy and concentration, better sleep, and an overall feeling of well-being.

If you practice IF, please share your experiences in the comments below -- what's your eating-fasting pattern, and what health effects have you noticed?

Andrew Weil, M.D., is the founder and director of the Arizona Center for Integrative Medicine and the editorial director of www.DrWeil.com. Become a fan on Facebook, follow Dr. Weil on Twitter, and check out his Daily Health Tips Blog.

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The advice to have five or six small meals daily has become common in recent years. I am 69 years old and don't recall ever hearing this as a child and seldom as a young adult, but by the 1980s it see...
The advice to have five or six small meals daily has become common in recent years. I am 69 years old and don't recall ever hearing this as a child and seldom as a young adult, but by the 1980s it see...
 
 
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08:07 PM on 07/17/2012
I lost nearly 20 pounds in 6 weeks through a form of IF: by skipping lunch every few days. I discovered I could go long periods without solid foods when I had to do a liquid fast before a colonoscopy. As long as I had electrolytes via Gatorade, I was fine. I've come to enjoy the lighter feeling I have on those days where I abstain from solid food for 10 or more hours. Once I take off a few more pounds I will probably keep doing IF as a maintenance thing once a month or so.
03:11 PM on 07/08/2012
I had been trying to lose weight almost my whole adult life (the past 50 years). I had tried every diet imaginable and found every one of them difficult to stick to. 4 years ago I read a short article in US News and World Report about people who fast at least one day a week. It said that these people were more likely to permanently keep off the weight that they lost this way. So, I gave it a try. I started by fasting one day a week, drinking only herbal tea all day long. I started losing weight. At first I found myself a little week a dizzy, but I persisted and gradually built up to 4 days a week. After the first few weeks it became easier and easier. I lost 45 pounds in the first 3 years and am now maintaining my new weight. I feel absolutely no hunger on the days I fast. I do feel lighter and less stuffed on those days and I eat less than I used to on the days I eat. The only negative effect is that I'm colder on those days - a real problem in the winter, but a boon on hot summer days.
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Michelle Zumbrum
Crazy book loving cat lady Liberal (And proud of i
09:42 PM on 07/09/2012
So you became an aneroxic? Because that is what it sounds like.
08:32 AM on 07/10/2012
No, I am definitely not anorexic ! On the days I eat I have whatever I want and I realy enjoy it. When we go away on vaction I eat every day and gain quite a few pounds, which I try to lose when we return home. According to my doctors I weigh just about the right weight for my height and age.
05:41 AM on 06/15/2012
I agree...For years, I'd been reading that you should never skip breakfast. Truth is, once I eat breakfast, I have to have another meal by afternoon, and I'm still hungry at dinnertime. Ive put on so much weight because of this. In contrast to the 'never skip breakfast' 'diet', Ive found that if I don't eat breakfast (cause I'm never hungry in the morning anyway), I usually won't feel hungry till about 1pm and sometimes even 3pm, and I start losing tiny amounts of weight almost immediately even without staying away from carbohydrates..I guess everyone just has to figure out what works for them..
02:25 AM on 06/13/2012
I've been doing intermittent fasting since February and I only have great things to say for it! I'm a 24 year old male who works a 9-5 and is very active ( I work out 6 times a week....5 days of weights, 3 days of boxing, and a 4 and 7 mile run.) I started Intermittent fasting because I was terrified of getting fat after starting my job. I started with skipping breakfast..and then slowly pushing my lunch back. It turned into a Dinner to Dinner fast that I did 3 times a week! Initially there is some adjustment but I realize that what we often mistake as physical hunger is psychological! This plan allows me to eat freely on my off days as well! Finally I'm actually in the best shape of my life and my world no longer revolves around my diet...that freedom is amazingly liberating! Please do it gradually and I say "Don't knock it till you try it!" Good Luck!
05:56 PM on 06/11/2012
I just posted a blog in late May voicing a similar sentiment (http://www.vitamedica.com/lose-weight-by-limiting-eating-hours/). Since late February, I have been fasting one day a week. I wanted to do this so I could lose about 6 pounds (which I've been largely successful in doing). I already work out 6 days a week and eat very healthy so cutting back one day a week was the only way I felt that I could accomplish my goal.

Since I can't stomach green/veggie juices, I've modified my once a week fast by having some grapefruit/tangerine juice in the morning then an apple or avocado in the afternoon and a small kale salad (about 1 cup) for dinner and perhaps a bit more juice. I still drink coffee because I do each Monday and need to work.

I find that the once a week fast is relatively easy to do and helps keep me more focused on the calories I consume in the successive days. My skin looks great (although typically does anyway as I eat very healthy). My day of workout rest I coincide with the fast.

It seems to work for me but does require some discipline.
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nisha
11:21 AM on 07/13/2012
That sounds like a cleanse, not a fast- a true fast means taking in only distilled water. It's a bit harder but a lot more effective. You only need to do it once a week.
12:53 AM on 06/11/2012
I like your idea of IF, but you're complaint against eating 5 to 6 times a day seems odd to me. This is how I eat, and I do fairly well maintaining my weight. I do not eat candy bars. My diet includes plain Greek style yogurt, almonds, pistachios, tomatoes, cucumbers, celery, tofu (extra firm), chicken (yes, even dark meat), fish, mangos, broccoli, carrots, apples, lettuce of all kinds, oatmeal, etc. First, I started off with small meals and then as I got down to my ideal weight, I increased the calorie content of those meals. I am quite happy with this method. I read up a lot on how to balance out my nutrition and received good counseling.

When I lived in a Latin American country, we ate that many times a day, and I lost weight. The difference? I didn't have a car to drive in all day and eat out of while stuck in traffic. So in the U.S. just cut back on the calories.

Eating regularly helped me keep from gorging myself. It helped me to think that I had a regularly planned eating time coming up in 2 to 3 hours and that I didn't need to think about making it to the next meal without a snack. Interestingly, I now really can't gorge myself. My stomach has shrunk so much that I can't eat as much as I used to in one sitting. It may not work for everyone, but it worked for me.
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02:31 AM on 07/09/2012
Good post.

I, too, don't believe "one size fits all" as an approach to eating.

People should be encouraged to learn what works for them.

I'm sure it would be easy for someone to write an article the opposite of Weils----why IF is bad for you and eating 5-6 meals a day is best.
05:58 AM on 06/10/2012
IF has more or less been my natural eating pattern all my life. Fostered partly by my mother's interest in healthy eating and having hardly any snack foods in the house. Meals had barely enough for small seconds, but were tasty and sufficient. Now I eat breakfast about 9:30 - almost always oatmeal with fresh ginger, cinnamon, a lot of almonds, no sugar or milk, sometimes raisins and always fresh fruit. I then eat my main meal about 3 or 4pm and then maybe fruit, yoghurt or cheese and crackers, or fruit about 8 or 9pm. I'm 64 now and have always been healthy with weight that varies about 3-5 pounds up or down. I try to eat organic, eat meat but rarely beef, very little sugar. If I don't have green things every day I feel malnourished!
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Sally Barry
10:49 AM on 06/09/2012
Here is a question. Does eating a big meal put you to sleep? This is a BIG problem for me, I simply cannot eat a big meal during the day, I get SO drowsy afterwards I'm afraid to drive. Makes it annoying when I'm invited to lunch - everyone is munching down enormous bowls of salad or sub sandwiches or fish fry on Fridays. I can't do it. I'm not being difficult/making a statement/it's all in my head - a lot of food during the day = sleepiness. After Thanksgiving dinner, everyone is suiting up to go out shopping, me, I'm sound asleep. What causes this??? Is there something wrong with my blood sugar, or ....what?
01:06 PM on 06/11/2012
Maybe your body is spending so much effort to digest all that food there's nothing left to keep your motor running.
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Joshua Maddox
02:59 PM on 06/13/2012
Eat the big meal at night
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Sally Barry
10:44 AM on 06/09/2012
I could NEVER 'fast all weekend' - that's when we get pizza, Chinese, cook on the grill, or go out to eat, on weekends!....I've been a grazer for as long as I can remember, we simply don't cook and eat three squares a day like grandma did. I really do try to pick healthy unprocessed things. I've never been able to eat breakfast in my whole life and get by on coffee coffee coffee and maybe a yogurt or banana . Lunch, a little of whatever is in the refrigerator, whatever is left over from last night. Don't eat a real meal until 9 p.m. when I can relax and let the digestion send me off to sleep.
01:38 AM on 06/08/2012
Thanks for this post Andrew, excellent information!
I have been IF'ing at least once a week for about 2 years now. Usually early Saturday evenings around 5pm to Sunday afternoon around around 2-3pm. Virtually everyday also, I will not have my first main meal till around around 10:30-11:00am.
Given that I rise from bed around 5am and have a very active lifestyle as nutritional consultant and H.I.I.T trainer, i experience no hunger or lack of energy issues what-so-ever.
My 2 main meals of the day are based on whole foods with a considerable amount of good fats, ethically and environmentally sourced protein and vegetable carbohydrates. Fats are absolutely critical on so many levels - and apart from the nutritional and hormonal benefits, fats SATIATE!
I do snack but mostly of nuts, seeds, goji + inca berrries and avocados. I make my own chocolate from Coconut Oil, Cocoa Powder, stevia and add either chili or almonds, or goji's as i do love chocolate.
Once you manage to IF successfully you will start to garner control over your eating habits, and take control of 2 hormones that play a key role in our consumption of food - Leptin and Ghrelin.
That in itself can be a struggle as they can be quite dictatorial.
I am 45 and enjoy not only splendid physical health, but very positive mental wellness. I am over enthusiastic about the need to proper food, nutrition, digestion, sleep & rest.
This works for me.
01:38 AM on 06/24/2012
I was just wondering on the days when you're IFing do you work out in the mornings on Sundays? If so, do you feel out of energy or do you feel fine? I have heard many things about how you shouldn't work out on an empty stomach, so I stopped doing that but honestly that way always felt the best to me. There's something about just waking up and getting right into a workout instead of having to eat a banana and cereal/yogurt and wait another 45 minutes to workout. Sometimes I'll just lose motivation because I have to wait. Also does doing IF help you with certain eating habits/problems such as food binging or bad cravings? (my horrible craving is chocolate, which btw your homemade chocolate sounds delish!)
06:31 AM on 06/24/2012
I generally train 3-4 days a week (every second day), and take a week off all training every 8-10 weeks. My daily training lasts no longer the 30-40 minutes - and usually involves Tabata protocol training, with a heavy weights session once a week focused on large muscle groups, completing traditional lifting - again for only 30-40 minutes.
The majority of the times i do not consume anything before my Tabata training apart from black coffee, however on occasions i may eat a little protein and plant carbohydrate.
Coffee is a great exercise motivator and some recent research articles indicate caffeine has some very positive effects on exercise performance :)
I will however, eat within 30-40 after training
Cravings - good fats seem to help with cravings for sugar and sweet foods. I also recommend to clients 5-HTP or Rhodiola to assist with will-power, cravings amongst other benefits.
Homemade choc 'is' delish!!
01:26 AM on 06/08/2012
I'm sorry but this is crazy stuff you are advocating

Basically Binging and then starving yourself
This is an eating disorder not a diet
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TinaFreeman
05:50 AM on 06/08/2012
If that is what you read, you don't get it at all.
12:25 PM on 06/08/2012
I get that lots of people have eating disorders
10:11 AM on 06/08/2012
hahaha, some of these responses have been very closed minded. this guy is a doctor and very wise
01:03 PM on 06/08/2012
doesn't seem very wize to me

Many women figured out that you can do what he is advocating and still eat every day. Its called purging
Most doctors woudn't recommend things like that

This one does for some reason. I'll stick with the majority on that one
12:46 AM on 06/08/2012
IF has changed my life. if i wasnt typing this on a tablet, id give the whole story. i ate the worst diet humanly possible .. 100% addicted to sugar. IF has given me COMPLETE control again and it was sooooo much eaiser than i could imagine and i eat ANYTHING i want. i needed to lose basically 100 pounds and ive lost half of it while eating pizza cookies and burritos and im talking fast food. if youre not hungry when you wake up and youre over weight ... this way of eating heals the body. think about the fake junk they put in foods. clears your mind. no more fog. its not a diet, its a way of eating for life because its so simple, it takes no effort - i cant think of one reason not to try it. eat pizza from pizza hut, eat at mds, eat at taco bell and get healthy!!
06:46 PM on 06/08/2012
But who wants to eat fast food? The issue not eating these foods because they're just not good for you regardless of what weight you are.
12:57 AM on 06/11/2012
Those foods are a lot of empty calories that include heart clogging ingredients. I'm glad the diet works for you, but why not eat the best to accentuate it?
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Chuck Bluestein
Always searching for latest health breakthrough
11:41 PM on 06/07/2012
Health enthusiast, Patricia Bragg, has been fasting for decades. She fasts every Monday and the first 3 days of every month. That means that she fasts one week every month. Some people have lost over a hundred pounds by fasting every weekend. Maybe the food industry came up with the idea of many meals a day so they could make more money!
11:12 PM on 06/07/2012
I'm a major advocate of IF and tend to take in the bulk of my food at night. I find I am unable to really enjoy and appreciate food when at work and prefer to eat when I am at home and comfortable. I still have a small bite for breakfast and a lunch, but these are all homemade veggie-intensive meals and usually low calorie.

At home, I eat a big salad with a lot of veggies and lean protein. Then I'll have Greek yogurt and whole grains like quinoa, millet, or rolled oats. To help my body digest and process the food, I take a digestive enzyme pill each night.

I've done this for a few years and enjoy it just fine. I can go almost all day on weekends without food and still function fine. It might be a slow change, but you feel less burdened by trying to eat every few hours.
08:34 PM on 06/07/2012
2-3 meals a day for me!! None of this 6+ meals a day crap! I can't do that. I would just feel like I was eating ALL DAY LONG.