I am the last person to promote a fad diet. My motto has always been “everything in moderation” and that holds true. However, as I watch the media highlight intermittent fasting (IF) and the ever-growing debate between Dr. Oz, who advocates for skipping breakfast and Mark Wahlberg who maintains that breakfast is the most important meal of the day, I thought I would weigh in from a personal and professional perspective.
Last year, I was diagnosed with pericarditis, which is inflammation of the lining of the heart. In addition to medication and monitoring, one of the treatments is heart rest and not allowing the heart rate to increase. In other words, I wasn’t going to be exercising for a while. In fact, it was nearly nine months of heart rest before I was cleared to resume normal activity. As every person knows, if you aren’t exercising and want to maintain your weight, you have to change your diet to compensate for the minimal physical activity.
As someone who refuses to adhere to fad diets, I was determined to find something that not only helps to maintain a healthy weight, but also something with longevity that I would be able to maintain. After a thorough academic literature search and thoughtful consideration, I decided to give intermittent fasting a try. I was hooked almost immediately.
For starters, you don’t have to buy anything to do it! No supplements, books, Apps, boxed meals. Nothing. Also, fasting may be difficult to initiate but once you start, it’s painless to maintain.
Think about every other diet, such as the South Beach Diet, "paleo" and "keto." The majority require drastic diet restrictions or consuming an excess of something you would hardly otherwise consume. These diets fail, more often than not, because they are extreme and rarely sustainable.
When it comes to fasting, there are two general rules of thought in terms of timing the fast. The first is known as 5:2, where essentially you eat a normal balanced diet five days a week and then fast for two. For some that may work, however I prefer the schedule where it doesn’t feel like you are essentially starving yourself.
The other method, which is my preference, is known as 16:8, meaning you fast for 16 hours of the day and eat during eight. The best part of this is the time you are sleeping counts towards your fasting! My schedule is that I don’t eat after 8:00 at night and then will start eating again around noon the following day.
The biggest challenge for me was my morning routine. I am a huge coffee drinker. Admittedly, I love the cheap sugary creamer. However, the purpose of the fast is to truly deprive your body of sugars during the fasting period, and to deprive your body of anything that would trigger insulin production. When your body is deprived of insulin, it starts burning your own fat for energy. That means that during the fasting window, you may only consume water, coffee and tea with no added anything (including lemon or flavored teas). No gum or mints, and nothing that contains calories or sugar.
This concept makes sense, because the food we consume is broken down in our body into sugar, which our cells will use for energy. If we don’t expend all of the energy through physical activity, our body stores the sugar in our fat cells. It's similar to a bear preparing for an upcoming hibernation. Our body stores energy in the event of starvation. However, we live in an obesogenic society where every activity is centered around food and alcohol, so we don’t really need as much stored energy as a bear. That's why America leads the world in obesity.
Sugar can only enter our fat cells when insulin (a naturally occurring hormone) is present, and it is released when we have an increase in our blood sugar level. Therefore, if we restrict the amount of insulin being released by not spiking our blood sugar, we will not only stop sugar from entering our fat cells but our body will break down the fat cells to be used as energy. The human body is quite brilliant; we just have to understand it better and make smart decisions to allow the natural physiologic process to occur.
Since I began IF nearly nine months ago, not only have I lost a few pounds, but I feel more energetic with fewer sugar spikes. We all joke about post-prandial fatigue, but it’s real. We tend to feel sluggish after big meals, so if we are having several a day, we are tired throughout our hectic lives.
The most important part of finding a diet that works for you is incorporating it into your life. I make my own little Bento box each morning as I am packing my kids’ school lunches. I make sure I consume a clean lunch once my fasting is over, so it’s filled with hard-boiled eggs, lean meat, fresh vegetables, and fruits. I also keep a stash of flavored dried seaweed and Parmesan crisps at work because I tend to crave salt in the afternoon, and these are the perfect low calorie/low carbohydrate remedy. When I come home, I eat a full dinner with my family. I am not counting calories. I eat the bread, pasta and even dessert if we are feeling adventurous. I have a glass of wine with my husband if the stars align and we both are home. The point is that I am not restricting myself and I’m not making it difficult for everyone around me to adhere to this diet.
This is what works for me. It may work for you, too, or it may not. When it comes to the human body and American life, there is truly no “one size fits all.”
I spend my days chasing after three kids, managing chaos in the hospital, seeing patients and occasionally making a TV appearance. My daily physical activity is composed of walking around the outside of the hospital and taking the two flights of stairs up and down to pathology after each biopsy I perform. For others, like Mark Wahlberg, a hardcore workout might be a major part of a daily routine. Because of the difference in schedules, we probably wouldn’t benefit from the same diet.
For people who exercise in the morning, many studies suggest they should eat something small before exercising, and follow it with a protein-rich meal, especially if they are wanting to build body mass. If they were to fast during this time, they might feel low-energy during their workout, which could lead to fewer benefits from the activity. They may even feel light-headed and pass out, which obviously is not ideal.
If they ate in the morning and fasted in the evening, it would mean no family dinners and no happy hours, no celebratory dinners. This is hardly a way to live, so I do not recommend it. Mental health and social connectivity are just as important as physical health.
Mark Wahlberg and Dr. Oz are both right. Skipping breakfast can be the greatest thing you do for yourself in 2020. However, it is also not for everyone, especially those with medical conditions or those taking medications where calorie restrictions may be harmful.
A healthy lifestyle that fits into your life is what will be best for you. Don’t be discouraged if you don’t see immediate improvements. You have your body for life, so make the long-term commitment. We didn’t become an unhealthy and overweight society overnight, so anything that offers a “quick fix” should be avoided.