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Is prolonged and intermittent fasting safe?

Is Prolonged and Intermittent Fasting Safe?

A doctor named Alan Goldhamer supervises patients through therapeutic fasting that lasts between 5 and 40 days. has reported ZERO deaths from water fasting, after having over 10,000 fasting patients. So, even though numerous adverse side effects can occur with water fasting, the mortality rate is extremely low (1). While I don’t recommend dry fasting or prolonged fasting without doctor supervision, it is highly possible that you could fast for many weeks without it being life-threatening. Prolonged fasts typically end much sooner than planned due to the psychological difficulty of going without food (2) in addition to the physical challenges of feeling hungry and unwell.

fasting-eating-schedule-breaking-the-habit

How long should you fast?

During autophagy, the human body is quite literally detoxifying. That said, it is best to listen to your body and break the fast if you start to feel sick. Fasting has significant psychological effects, like the keto diet due to our bodies need for carbohydrates (2). In some cases, people fast for several days or weeks, then safely return to good health upon breaking the fast with mostly water and health foods. In other cases, fasting for long periods of time can have detrimental effects on people’s health. While some studies have shown that multiple-day fasts are beneficial to human health, more research should be done on best practices.

Most people view starvation as an entirely bad thing – even if it means skipping only one meal – thinking it’s just another type of calorie restriction with short term results. While this can be true for fasting, the negative effects of starvation are more likely to occur when you put yourself on a very low-calorie diet (VLCD). One study determined that after 10 weeks of undereating (due to VLCD without fasting), your hormones change and cause you to feel extra hungry for the next year or longer, leading to weight gain in the long run (3).

water-fasting-dry-fasting-health-benefits

Some people develop a liking for fasting, and practice it regularly.

A 24-hour fast every couple weeks or a daily 16-hour intermittent fast is generally safe for healthy individuals. Intermittent fasting has gained popularity in recent years and has been proven effective for fat loss in many studies (4). Many people find that it feels completely normal to go without food from dinner until the following day at lunch time, which is why the 16-hour fast is usually a good starting point. Some people start with 12 hours, then slowly build up over time to achieve 16-24 hour fasts through practice. Many fasters go beyond the 24 hour mark for days or even weeks to reap the health benefits. However, with the risks associated with prolonged fasting I do not personally recommend it. In fact, a 2017 study shows that intermittent fasting has all the same benefits as prolonged fasting such as weight loss, improved liver function, and glucose homeostasis (5).

When intermittent fasting, choosing a vegan version of the ketogenic diet during your eating window is much less harmful to our bodies than the animal-based version. Low-carb plant-based foods may reduce risk of heart disease as opposed to increasing the risk (like meat does) (6). However, it is not required to eat low-carb foods to reap the benefits of ketosis when fasting. Regardless of what diet you follow, make sure you are getting enough calories, proteins, vitamins, and minerals. If you have an eating disorder, nutrient deficiency, or Type II Diabetes, you should not attempt fasting. Hire a vegan dietitian, nutritionist, or nutrition coach to help prepare a healthy and safe plan for you. As always, talk to a medical professional before making any diet changes and to discuss any health risks associated with fasting.

Written by Kelly Gibson, Owner at Kelly Athletics LLC. Kelly is a Personal Trainer and Holistic Nutritionist in Pittsburgh Pennsylvania. She is passionate about being a vegan coach, and loves to help women transition to a plant-strong diet.

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References:

  1. Gustafson, Craig. “Alan Goldhamer, dc: Water Fasting—The Clinical Effectiveness of Rebooting Your Body.” Journal of Integr Med (Encinitas). Vol 13(3): 52–57. Published June 2014. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4684131/. Accessed Aug 3, 2018.
  2. Mehrpour, Maryam et al. “Autophagy in health and disease: 1. Regulation and significance of autophagy: an overview.” American Physiological Society, vol 298, issue 4. Published April 2010. https://www.physiology.org/doi/10.1152/ajpcell.00507.2009. Accessed August 1, 2018.
  3. David Baker and Natacha Keramidas. “The psychology of hunger.” American Psychological Association. Published October 2013, vol 44, No. 9. http://www.apa.org/monitor/2013/10/hunger.aspx Accessed July 29, 2018.
  4. Kollias, Helen. “Weight Loss & Hunger Hormones: Why ‘willpower’ may not be your problem.” https://www.precisionnutrition.com/fast-weight-loss-changes-hunger-hormones. Accessed July 31, 2018.
  5. Moro, Tatiana et al. “Effects of eight weeks of time-restricted feeding (16/8) on basal metabolism, maximal strength, body composition, inflammation, and cardiovascular risk factors in resistance-trained males.” J Transl Med. Published 2016. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5064803/ Accessed July 24, 2018.
  6. Kyoung-Han Kim & Yun Hye Kim. “Intermittent fasting promotes adipose thermogenesis and metabolic homeostasis via VEGF-mediated alternative activation of macrophage.” Cell Research Journal. Published Oct 17 2017. https://www.nature.com/articles/cr2017126.  Accessed July 31, 2018
  7. DJ, Jenkins et al. “Effect of a 6-month vegan low-carbohydrate (‘Eco-Atkins’) diet on cardiovascular risk factors and body weight in hyperlipidaemic adults: a randomised controlled trial.” BMJ Journals. Published Feb 5 2014. https://www.ncbi.nlm.nih.gov/pubmed/24500611 Accessed July 25, 2018.
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Why the Keto Diet Isn’t So Great

Why the Keto Diet isn’t So Great

An inside look at the ketogenic diet

Recap: In the previous article we discussed some benefits and downsides of the keto diet. We left off with an unanswered question about how people could possibly be reporting fatigue, demotivation, and moodiness on the diet when ketosis is supposed to provide people a newfound level of energy.

Analysis: Sugar withdrawal by itself can cause these symptoms, but only for a short time like within the first week of giving up sugar. Even if you exclude processed sugar by going keto (a good thing), a diet without carbs is a diet without fiber (a bad thing).  In order to have regular digestion and a healthy blood cholesterol level, we need fiber! A low-fiber diet can cause constipation and gastrointestinal pains at the very least (1). A psyllium husk supplement could help you regulate, but did you know that by using supplements in place of whole food ingredients you can worsen your health (2)? If carbs aren’t the only thing lacking on a ketogenic diet, what is?  You might be thinking you have plenty of healthy options because the keto diet includes nuts, seeds, avocado, and a variety of vegetables. Unfortunately, only a moderate amount of those can be eaten, because they, too, contain carbohydrates.

strawberry-limited-fruit-intake-keto-diet

Say goodbye to having big bowls of fresh fruit on the keto diet.

Deficiencies: Nutritional deficiencies are known to impair the ability AND desire to exercise, as well as causing emotional distress and mental difficulties (Clark 477). A minimal amount of fruit and vegetables is allowed in a keto diet, and (aside from soy and peanuts) there are no legumes, starches, or any grains allowed at all. A diet that emphasizes reducing fruit and vegetable intake can severely lack phytonutrients (such as carotenoids and flavonoids) thus increasing risk of disease (4). Vitamin A is limited in animal-based foods, while Vitamin C is practically non-existent.

Prevention: If you want to safely prevent a deficiency on a keto diet, you will have to carefully plan how to get your vitamins with superfood ingredients that carry a lot of weight for such a small amount of food.

vitamin-b12-vitamin-c-b-complex-a-d-e-k

Vitamins Can't Replace Food

To ensure that you get enough vitamin A and C you could eat a cup of raw kale every single day, but you may struggle to get it in when you are limited to only 5-10% of your overall calories from carbs. Vitamin C deficiency can cause Scurvy – a dangerous condition that can harm your teeth, metabolism, immune system, and iron absorption. Early signs of anemia could also affect energy, emotions, and mental health.

 

potatoes-nearly-5g-fiber-per-potato

Potatoes, excluded from the keto diet, have 5g of fiber.

Satiety: High-fat diets in general are strongly associated with obesity, likely because it is so easy to overeat fats (Clark 456). So even though ketones can boost weight loss, a calorie deficit is necessary for burning fat.  Be prepared to portion tiny meals to stay within your calorie budget on a keto diet. If your stomach is only partially full (since high-fat foods lack water density), your hormones might not signal to your brain that you are satiated. It is well-established that fibrous foods low in fat are more likely to trigger satiety, while foods high in fat are more likely to cause overeating (4). Ironically, overeating fats doesn’t seem to increase the sensation of satiety either (4).

Summary: This is just a few examples of pitfalls that come with the keto diet – how will you keep going when the very foods you are eating for weight loss is draining you of energy? Taking a multivitamin is an option, but studies show it is not safe to replace your fruits and vegetables with a supplement (5). In other words, a supplement should be taken in addition to a healthy well-rounded diet. Limiting produce is dangerous for your health because plants contain the very nutrients that keep us healthy and fight disease! Don’t get me wrong – ketosis by itself is an awesome benefit of the keto diet, but is there a safer way to go keto? Continue on to the next article to find out!

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Resources:

  1. “Implications of Fiber Inadequacy in the Ketogenic Diet: A Case Study.” Wendy J. Dahl, PhD, RD, Elaine J. Niebergall, RD, and Russell J. Owen, BS. ICAN: Infant, Child, & Adolescent Nutrition. Vol 3, Issue 5, pp. 288 – 290. First Published September 13, 2011. https://doi.org/10.1177/1941406411422253. Accessed Jul 18 2018.
  2. Johnston, C. S. (2012). Vitamin C. In Present Knowledge in Nutrition: Tenth Edition (pp. 248-260). Wiley-Blackwell. DOI: 10.1002/9781119946045.ch16. https://asu.pure.elsevier.com/en/publications/vitamin-c. Accessed Jul 18 2018.
  3. Clark, Michael A et al. “NASM Essentials of Personal Fitness Training”. Fourth Edition, Textbook Published in 2012. Lippincott Williams & Wilkins, a Wolters Kluwer business.
  4. Phytochemicals.” Linus Paulis Institute: Oregon State University. Micronutrient Information Center: Dietary Factors. http://lpi.oregonstate.edu/mic/dietary-factors/phytochemicals. Accessed Jul 17 2018.
  5. Chambers, Lucy et al. “Optimising Foods for Satiety.” Elsevier: Trends in Food Science and Technology. Vol 41, Issue 2, pp. 149-160. Published February 2015. https://www.sciencedirect.com/science/article/pii/S0924224414002386. Accessed Jul 19 2018.

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Ketogenic Diet: The Good, The Bad, and the Ugly

Ketogenic Diet: The Good, The Bad, and the Ugly

Written by Kelly Gibson

Introduction: I’ve been in the nutrition field for about six years, after mastering extreme weight loss on a plant-based diet. Not a day goes by that I don’t see ads for foods that I no longer eat – from food delivery services to chain restaurants to supplement companies trying to get me to sell their products. Businesses are constantly piggyback marketing by creating new foods to make the latest diet easier on people by selling custom meals and supplements. If more people knew what I knew about these marketing tactics, they just might stop falling for it. In just the past year I’ve been bombarded with ads and inquiries about the new ketogenic diet. I finally decided to shed light on what this diet is all about including the good, the bad, and the ugly.

Kelly Gibson - Nutrition Coach

The Keto Plate: The keto diet first came about in the early 1900s (1) but didn’t become a “thing” for quite some time. It’s been gaining popularity for quick fat loss recently, and even for cancer treatment. The ketogenic diet specifically aims for a macronutrient profile of 5-10% of calories from carbohydrates, 60-75% calories from fat, and 15-30% calories from protein. A lot of keto dieters aim for 30 grams or less of carbs, as a general rule of thumb; eat one banana and you’ve exceeding your carb limit for the day!  The good thing about the keto diet is protein intake is moderate and people don’t have to stress over counting calories. Unfortunately, they need to achieve out-of-the-ordinary low-carb and high-fat goals in order to master the keto diet.  This diet is primarily comprised of meat, eggs, oils, animal fats (like lard, tallow, bacon grease, and goose fat) in addition to full-fat dairy products (like mayo, butter, and heavy cream).

sample-keto-plate-ketogenic-diet-food-pyramid-kelly-athletics

The Good: The main purpose of going keto is for the body to raise ketone levels and enter a state of ketosis. Ketones are – in simple terms – an alternative energy source to glucose, which our brain and body primarily functions on. Ketosis can happen when you take a break from eating carbohydrates and build up ketone levels. In ketosis, your body switches from carbs to fat for fuel, allowing it to perform key functions in the brain and body (Berardi 65). Some research suggests that ketones burn fat faster than glucose, which is why there is so much hype about this diet. A good thing about this low-carb diet is that people have no choice but to avoid processed sugar. Common benefits people have reported from going keto is lower triglycerides, more energy, and reduced seizure activity (3).

sample-keto-diet-gelatin-dessert-gummy-bears-jello

Sample keto dessert: gelatin gummy bears with artificial sweetener

The Bad:  Even a little bite of fruit or dessert could throw you over your carb goal for the day, and kick you out of ketosis. Unfortunately, people resort to low-calorie sweeteners or even artificial sweeteners if they really want to treat themselves. Even though there are no carbs in sugar-free treats, artificial sweeteners can create an insulin response, increasing appetite and causing weight gain (5). Negative side effects that some keto dieters report is mood disturbance, fatigue, and lower motivation to exercise (4). This, in and of itself is counterproductive to weight loss and could be a sign of malnutrition.

The Ugly: You’ll be shocked at what you find out about the ketogenic diet… Go to the next page to reveal how ugly this diet can be.

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Resources:

  1. Mandal, Ananya. “History of the Ketogenic Diet.” News Medical, Jan 12 2015https://www.news-medical.net/health/History-of-the-Ketogenic-Diet.aspx. Accessed July 16, 2018.
  2. Berardi, John et al. Precision Nutrition: The Essentials of Sport and Exercise Nutrition, Second Edition. Precision Nutrition, Inc., 2012.
  3. Kossoff, Eric. “Ketogenic Diet.” Epilepsy Foundation, Oct 2017. https://www.epilepsy.com/learn/treating-seizures-and-epilepsy/dietary-therapies/ketogenic-diet. Accessed July 17, 2018.
  4. White, A. M., Johnston, C. S., Swan, P. D., Tjonn, S. L., & Sears, B. (2007). “Blood Ketones Are Directly Related to Fatigue and Perceived Effort during Exercise in Overweight Adults Adhering to Low-Carbohydrate Diets for Weight Loss: A Pilot Study.” Journal of the American Dietetic Association107(10), 1792-1796. DOI: 10.1016/j.jada.2007.07.009. https://asu.pure.elsevier.com/en/publications/blood-ketones-are-directly-related-to-fatigue-and-perceived-effor. Accessed July 17, 2018.
  5. Yang, Qing. “Gain weight by “going diet?” Artificial sweeteners and the neurobiology of sugar cravings.” Neuroscience 2010. Yale J Biol Med. 2010 Jun; 83(2): 101–108. Accessed July 18 2018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2892765/

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