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Intermittent Fasting for Health Professionals

Intermittent Fasting for Health Professionals

This blog post is a bit more `sciencey’ than our usual blogging style as it’s written with Nutritional Therapist’s and other Health Professionals’ in mind. Here we look at why Intermittent Fasting works, the various regime definitions and how best to support your clients on their fasting journey. A fully referenced version can be requested via the `contact us’ page.

Why Intermittent Fasting works

When food is available, the human body has evolved to burn glucose for fuel and to grow.  When it is scarce, it has evolved to use stored fat for fuel and to repair.  Increasingly, modern life is associated with a disproportionate time spent in growth mode due to high eating frequencies, high calorie intake, sedentary lifestyles, chronic stress and longer life spans.  This dysregulation is associated with increased incidences of obesity, metabolic disease and diminishing health spans.

Intermittent fasting helps redress this balance.  The benefits most associated with intermittent fasting are weight loss, metabolic flexibility and as a strategy to age well.  It can also be a useful client protocol for other states such as those associated with brain or gut health and auto immune conditions.

Types of Intermittent Fasting

The term intermittent fasting is an umbrella term covering a range of regimes that oscillate between periods of eating and not eating, without malnutrition.  In general, these fasts are classified as either periodic fasts or time restricted eating.

Periodic fasts cover regimes where no calories or a restricted calorie allowance are consumed for a period of time and includes water fasts, alternate day fasts and fasts that include some calories such as the popular 5:2 regime and the alternate day modified fast.

The benefits of this group of fasts are mediated by switching primarily to fatty acids and ketones for fuel and inactivating nutrient sensing pathway mTOR (mechanistic target of rapamycin) to stimulate cellular repair, autophagy and pro-ageing epigenetic factors.  Fat and fatty acids support these transitions while glucose and amino acids inhibit them.

Therefore, for plans with a calorie allowance, it is increasingly being recognised that macronutrient composition plays a role in achieving the calorie restriction benefits.  For clients focused primarily on weight loss, consider lower carb options for those meals and for clients focused on the cellular repair benefits, exclude the amino acids methionine and cysteine as these are particularly potent activators of the associated pathways.  For all periodic fasting plans with a calorie allowance, recommend calories are consumed in one sitting, except for a small amount of fat if needed for compliance.

Time restricted eating regimes are plans where all food is consumed within a set time frame each day, typically less than 12 hours.  A popular version is 16:8 where all food is consumed within 8 hours.  Benefits are mediated by the same pathways as periodic fasts and additionally by syncing the individual’s circadian rhythm with their daily cycle of feeding and fasting.  A dysregulation of this cycle is associated with excess calorie intake and accelerated ageing.  Regular periods of this type of intermittent fast regulate these transitions and rhythms.  It is important to note that any calories consumed during the fasting window start the biological clock.  If those calories are from fat, the benefits associated with periodic fasts continue.

The right regime depends on individual client goals and lifestyle fit.  Whatever the format, compliance can be difficult, especially over the long term.

Client considerations

Some clients will find adhering to an Intermittent Fasting harder than others. For example, clients with a degree of insulin resistance may require more support to adhere to their fasting plan.  Insulin resistance delays the onset of the metabolic switch over to fatty acids causing a metabolic imbalance.  Glucose and glycogen stores run low while insulin levels are relatively high so fatty acids cannot be accessed.  This results in symptoms typically of hunger, moodiness and tiredness and reports of lapsing can be common during this time.

A recent study demonstrated that beliefs may also play a role in adherence to an intermittent fasting plan.  Lapsed intermittent fasters were more likely to believe that a healthy meal plan included three meals a day and regular snacks.  Whereas current intermittent fasters were comparatively unconcerned about skipping meals and were less likely to believe that breakfast was the most important meal of the day.

Before a client starts an intermittent fasting programme for those with insulin resistance, consider reducing daily eating frequency to 3 meals only within a 12-hour period for several weeks.  For those with beliefs that intermittent fasting protocols are unhealthy, consider providing research and support to negate long held assumptions. 

Intermittent fasting is a mild stressor.  Assess a client’s overall stress tolerance and load to ensure that they do not become chronically stressed as this will negate the favourable hormetic response from fasting.  In addition to lifestyle and nutritional stressors, it is important to understand that if the client is undertaking any additional intermittent challenges (such as high intensity exercise, saunas or cold showers etc.), as these are also mild stressors and have an additive effect.  An intermittent fasting regime that is too advanced can also be a stressor.  As the client becomes more proficient at fasting, adding other intermittent challenges and more advanced fasting protocols can be useful progressions.

Prepare clients with relevant tactics for use during their intermittent fast:

-          Educate on how to differentiate between typical symptoms (hunger that passes, mild tiredness, moodiness, mild headaches) and those that indicate fasting is too stressful and the fast should be broken (significant day time tiredness, dizziness, feeling overwhelmed).

-          Advise on useful strategies for those days where they are struggling.  For example, sodium may be useful for some clients who have a history of electrolyte imbalance, black coffee and green tea can help with hunger pangs, MCT or coconut oil can support those struggling with hunger on periodic fasting regimes, apple cider vinegar can support insulin sensitivity and calorie restriction mimetic compounds can support the main fasting pathways overall.

-          Calorie restriction mimetic compounds?  These are components of some foods, often as polyphenols.  The most commonly known include resveratrol, curcumin and quercetin.  Current research indicates that this group of compounds mediate metabolic flexibility and support the transition of mTOR into repair mode where autophagy and longevity genes are activated.  A synergistic blend of these compounds is useful as specific modes of actions and target sites vary. Here at Nutritionist’s Blend we use calorie restriction mimetics in our FASTING+ fasting sticks.

Ensure clients understand how to eat during their eating window:

-          As intermittent fasters tend to have less eating opportunities, nutrient density is a useful area of focus.  For those primarily focused on weight loss, lower carb or keto protocols may be appropriate.  In addition, a calorie deficit may or may not be required depending on the selected programme.

Due to genetic and environmental variation, an individual’s response to fasting can vary both in general and on a daily basis.  Intermittent fasting success is a constant balance between progress and ensuring it is a regular and repeatable practice for clients.  If done correctly, compliance and progress can be long-term supporting a more optimal balance of cellular growth mode and cellular repair mode.  This could help normalise weight, support more consistent energy levels and support healthier ageing.  Regular client check-ins and programme reviews are therefore recommended, particularly during the first few months.

We hope your clients achieve their fasting goals

Nutritionist’s Blend team x

Easier Fasting

Easier Fasting

For Periodic Fasters'. Such as those of you following 5:2, 4:3, Alternate Day Modified Faster's or similar.

Some days fasting days can suck. And it can be hard unravelling what made that day so much harder than usual. Could be hormones, a hangover, too many or not enough carbs the day before or you might just be tired, really busy or really bored.

Having a strategy can really help you avoid those horrid days. Here we take a look at things you can do to help you out on the day itself and things you can do in the lead up to a fasting day to make sure you stay on track.

The fasting day itself

1-      Stay busy. But not too busy. Being busy gives you a distraction from thinking about food all day. But being stressed can make all those good intentions fly out of the window. Aim for some kind of balance if at all possible.

2-      Treat yourself to things that aren’t food related. For example, it’s lunchtime. You need a break. You are thinking about the food you can’t have. Have a stick of FASTING+ then it's time for a distraction. Go for a walk around the block. Grab a coffee and read a chapter of a book you’ve been meaning to read for ages. Plug in some guided meditation. Escape to a yoga class. Have a manicure. Phone a friend. Go to the aquarium. Whatever works for you but take a break. After all you are fasting for health not punishing yourself.

3-      Get some sleep if you can. Okay this isn’t going to be an option for everyone but if you can schedule it, sleep in a little later than usual (after all you don’t need to allow time for breakfast today) or go to bed earlier than usual. And if you really own your own diary (or live in mainland Europe) grab an afternoon nap.

4-      Actively manage hunger and cravings. Water, black coffee and FASTING+ sticks will help with hunger. If you are craving salty or sugary foods or getting a mild headache remember the body loses salt during a fast and those cravings may just be a side effect of that. Instead of reaching for a bag of salt and vinegar crisps or a chocolate biccie try one of these instead: ½ tsp sea salt with a pint of water or a few olives, a small bag of nori seaweed crisps, a cup of miso soup or bone broth. 

5-      Stay hydrated while reducing the monotony. Still water is the mainstay of fasting but it can get rather dull.  To liven it up you could add herbs (mint is a classic) or a squeeze of lemon but there are many other approaches to mix things up. Black coffee is your friend. Treat yourself to the best you can afford. Switch to decaff from 3pm or stick to decaff full stop if caffeine is an issue for you. Schedule your coffee breaks for a time when you tend to struggle or need a lift as it has the added benefit of reducing any hunger pangs you may be experiencing.

If you don’t like coffee but still need a coffee-shaped lift try matcha tea – hot or cold. But yes a matcha Latte is cheating. Matcha tea is amazing stuff. You get a lift from the caffeine but it's also rich in L-Theanine which can improve concentration levels. If you need a power hour to focus on getting a pile of work done then this is for you.

Tea is also allowed on most periodic fasting regimes. Nothing wrong with breakfast tea but experiment to keep things interesting. Green, peppermint, chamomile, rooibos are always popular but expand your repertoire. During a fast, warming teas can be comforting-  pu'er and coconut chai are worth seeking out as is anything with cinnamon, cocoa or liquorice in it. 

Use your none-fasting time to set you up for easier fasting

1.       Get some sleep – yep, that again.

2.       Ditch the alcohol… and the sweets… and the chocolate… and the white carbs… and the white pasta. I know, boring! But as boring as it sounds, reducing your refined carbohydrates outside of your fasting window will help support insulin and blood sugar regulation making the transition into a fasted state easier. You don’t have to go to extremes. Just be aware of what you are eating and try to add in some fat, fibre or protein to reduce the overall effect of any refined carbohydrates.

A few tips;

§  Focus on getting your carbs from vegetables and fruit and leave the skin on where possible for extra fibre and extra nutritious goodness

§  Drizzle extra virgin olive oil on your veggies and salads

§  Add full fat yogurt to your fruit

§  Choose high cocoa chocolate and have it with some nuts or seeds

§  Ditch the top of your sandwich and pile the filling high

§  Have one glass of red wine with a meal and savour it

§  Stir a tablespoon of coconut oil into your porridge before serving

§  If you can choose between full fat or low fat, always choose full fat 

3.       Eat enough. Of the good stuff. Don’t go into diet mode on none fasting days. Eat proper meals of proper food in proper amounts. This will help you stay on track when you fast and support your metabolism. Try not to over eat though and try not to have snacks between meals. The odd treat? Why not.

4.       Do your hard, high intensity training sessions – weights, sprints, endurance work etc. on a non-fasting day… maybe. The jury is still out so feel free to try exercising on a fasting day and none fasting day and find out what works best for you. Some say HIIT (High Intensity Interval Training) is brilliant on fasting days as it improves the fat burning benefits of a fast. Others say fasting days should be limited to low intensity training.

If you are trying to lay down muscle, best to do that on a none fasting day. Or you could be clever about how to time the calories you do have – eat something high in carbs an hour, hour and a half before training (such as fruit) and something high in protein and carbs post training (such as meat and veggies). If you are fasting to lose fat, give fasted training a go. 

If you decide to exercise during your fast, stop immediately if you feel dizzy or your energy levels drop significantly and give yourself a break. If you can, try and work out why it was hard for you on that day - trained too hard the day before? Not enough sleep? Too much on at work? Poor diet during the lead up to the fast? Etc. so you can adjust things for next time.

On balance woman tend to struggle with training during a fast more than men (thanks hormones) so ladies be extra aware of any changes and adapt your programme to work for you.

I hope some of these work for you. Happy fasting. x

A beginners guide to Intermittent Fasting

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A beginners guide to Intermittent Fasting

Fasting and Intermittent Fasting are used as a tactics by those looking to lose weight (especially for shifting that stubborn weight around the middle), improve energy levels and to support ageing well.

The key difference between Intermittent Fasting and fasting is that Intermittent Fasting plans tend to be more achievable as you still get something to eat on a fasting day. This is key because following a regime over the short term is useful for weight loss and energy gains but it's long term adherence that supports long term wellness and longevity.

Popular Intermittent Fasting plans

All Intermittent Fasting plans follow the same core principles that there are some times that you eat and some times when you fast. The difference between the plans is the timing and length of those periods. The most popular plans are listed below:

5:2. This is a weekly plan where you eat normally for 5 days and then have 2 days where you consume 500kcal if you are female and 600kcal if you are male per day only, ideally in one sitting. Your fasting days do not have to be consecutive. So you could decide to fast on Monday and Thursday and eat your standard diet on all other days.

4:3 is the same as 5:2 except, you eat normally for 4 days and have 3 days where you consume 500-600kcal per day. 

Alternate day fasting follows the same principles as 5:2 and 4:3 but you eat normally on day 1 and consume 500-600kcal on day 2. This pattern is then repeated with one day on and one day off throughout the week.

16:8 is a daily plan where you fast for 16 hours and consume all of your food within an 8-hour window. For example you may to choose to eat only between midday and 8pm every day. There is no daily calorie limit to what you eat in your 8 hours but do aim for a healthy balanced diet wherever possible.

Water, herbal teas, tea and coffee can be consumed throughout during these formats of Intermittent Fasting.

Choosing the best plan for you

Decide if a daily or weekly approach suits your lifestyle better.

If weekly, look at 5:2, 4:3 or Alternate Day plans and decide how best to fit your plan into your life.

For example, would you prefer to be busy or quiet on fasting days? Which days have less temptation for the coming week? Fasting on a day where you have a social engagement that centres around food and drink may not be the best choice for you.

It's also important to decide roughly what time you will aim to eat your daily calorie allowance factoring in things that are import to you such as breakfast or dinner with family, partner, housemates.

Taking these factors into account will help give you the best chance of success.

Daily, look at regimes that take a 16:8 type approach

To come up with a version of the plan that works for you consider which 8 hour eating window fits best with your lifestyle. 10am-6pm? Midday-8pm? Something else?

Also have a plan on what approach to eating will work best for you during that window. Are you going to have 2 or 3 meals? 2 slightly larger ones?2 meals and a snack? Or would viewing it as skipping either breakfast or dinner make it easier? 

Fasting is not for everyone.

Please keep in mind that fasting and Intermittent Fasting is not suitable for everyone. It is not suitable for children, during pregnancy, for those who have/had an eating disorder such as anorexia/bulimia, have or are recovering from adrenal fatigue or for type 1 diabetics.

For those with type 2 diabetes, thyroid conditions and nursing mothers or other underlying medical conditions please seek medical advice first before attempting fasting. In addition, seeking advice from a Nutritional Therapist or other health professional could be of benefit.

Getting started

If Intermittent Fasting is right for you, give yourself the best chance of success by adjusting your diet in the days and weeks leading up to starting your Intermittent Fasting plan.

You are looking to achieve a reduction in insulin and stress hormones. This is not about calorie reduction or weight loss but instead about reducing your reliance on refined carbohydrates, reducing eating frequency and supporting overall hormone balance.

Tip 1 reduce your bodies reliance on sugar for fuel

• Reduce sugar intake (for example sweets, chocolate, cake, fizzy drinks, fruit juice etc.)

• Reduce refined carbohydrates (for example bread, pasta, cereals etc.)

• Add fat or protein to all meals (for example eggs, avocado, olive oil, butter and other full fat dairy, nuts, seeds, meat, fish)

Tip 2 reduce snacking

• Aim for 3 meals a day only

Tip 3 aim for 6-9 hours of quality sleep per night

• Consider bedtime routine

• Screen time

• Caffeine

Tip 4 look to minimise the impact of stress in your life

•Reduce it

•Manage it

Tip 5 Improve nutrient density of your diet

• Add more vegetables and some fruit to your meals (aim for all colours of the rainbow)

• Be liberal with the use of herbs, spices, sprouts and seeds

• Choose natural, unrefined foods when possible

Or if you are an all or nothing kind of person, just give your chosen plan a go and see how you get on. If feel energised and have great concentration level's then carry on! If you feel dizzy, experience day time tiredness or just feel strange stop fasting immediately and eat something.  You can always try again another day.

Remember its perfectly normal to feel hungry in waves during your fasting period but these pass within about 15 minutes. Mild hunger is not a reason to stop your fast. Instead have a glass of water, a cup of black coffee or a sachet of Fasting+ and reassess how you feel. Read the `Easier Fasting' blog for more practical tips.  

For those of you who decide to give Intermittent Fasting a go, welcome to the club and happy fasting x

 

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