Fasting within the Framework of Optimal Health

Taking Another Look at Intermittent Fasting and Time Restricted Eating

Last Fall I had the pleasure of hosting a few zoom calls on fasting. It took me a long time to come around on the topic of fasting, due to my own experiences with it over the years. My body type is not the most conducive to fasting and I had my share of challenges with it over the years, as those of you on the calls know.

I came around on it due to the significant benefit that I observed in a number of individuals I have had the honour of working with that were engaged in practices of fasting. I also learned a lot from the ground breaking work of Dr. Jason Fung MD and later, Dr. Mindy Pelz DC. I am very grateful for their work and I know that many people have benefited from these therapeutic approaches - not only in blood sugar regulation but also gut and immune healing, and issues related to neurological function such as cognitive decline, to name just a few of the beneficial outcomes.  I believe that fasting is the natural antidote to the consequence of the excesses of our modern western lifestyle and dietary choices.

It brings be back to the yin and yang of the universe. One extreme can only lead to its opposite extreme. This is why I am an advocate of the middle road whenever possible. 

Over the years I have felt that two polarities are at work in the field of nutritional health and wellness:

1. The optimal nourishment perspective which to me feels very yin. It is tied to supporting optimum fertility and health of our children and future generations. We can see this best expressed in the work of Dr. Weston Price and the many people who have benefited from this approach especially since its emergence in popularity over the last few decades.

2. On its opposite end, we see the longevity perspective which feels to me to be more yang and “driven” in its approach. It is tied in to calorie restriction, carb restriction and time restricted eating as ways to best support longevity and health as we age.

There is a place for both approaches from a therapeutic perspective. However the extreme cultivation of any one side of this continuum can lead to imbalance. We need to figure out where we might be out of balance - either from inherited patterns, our body type tendencies, or from the fallout of past dietary and lifestyle choices. Based on that kind of clear perspective, we can better understand how to use these therapeutic approaches with benefit. Any time we blindly act from a purely intellectual or dogmatic stance, we fail to listen to the guidance of our bodies in our process of healing. 

Some of you that participated in the zoom calls on fasting last Fall may be wondering what ever happened to the follow up class I had planned to offer in the New Year. Well, that never quite materialized :) Over Christmas I was down and out with a flu bug and ended up fasting by default for about a week. I know it was the best thing to do for my body through the acute phase of that illness. It was an amazing reset of my system and I was very much renewed and revitalized. I was aware that coming out of that experience was not a time to be doing more fasting.  As such, I kept waiting for the guidance on when to teach that follow up fasting class. It still has not materialized. Instead the last 3 months have been focused on nourishment and rebuilding.

Dr. Mindy Pelz, the author of Fast Like a Girl, who has been a strong advocate of fasting for a number of years and has helped many people in this realm made a very courageous choice over the last number of months. She took a step back from her usual work demands and fasting routines in order to deeply nourish and heal the body and reset the nervous system. I deeply respect anyone who listens to the guidance of their body and acts from that place.

We need to keep in mind that extremes are never the best solution in the long run. Instead, we need to listen to our body and to our internal guidance system. Any time we engage in extremes we are left dealing with the fallout of those choices, which often leads us to their opposite.

You may have come across information in the news this past week showing fasting more than 16 hours per day may be associated with adverse health outcomes, specifically increased cardiovascular risk. It has not yet been associated with all cause mortality. This news is based on very preliminary research and has many significant questions still unanswered that will become clearly in further analysis of the research. I find it fascinating that research has come out on this topic and I am not convinced that these results are applicable to those engaged in moderate use of intermittent fasting. From my perspective, interest in intermittent fasting from a health perspective has really only been in the public domain over the past decade. I can’t imagine there has been enough time to truly gather large scale data on the longterm health benefits of intermittent fasting.

When I think about longterm population studies on the outcomes of fasting for more than 16 hours per day, I wonder about the demographics of the population they are studying that fits those parameters. In my clinical practice, the people that most often fit this parameter have issues with disordered eating, severe calorie restriction, with overuse of alcohol or just smoke cigarettes and drink coffee all day instead of actually eating. It will be interesting to see in the long run how the populations that engage in 16 plus hours per day of fasting due to the above reasons, versus those that engage in moderate and judicious use of intermittent fasting as part of a healthy lifestyle and eating pattern over the long run fare.

I believe most adults should be fasting at least 12 hours overnight. The body needs time to reset itself and engage in metabolic housekeeping on a daily basis. Without this daily break from eating, the processes of elimination becomes overburdened and we also increase our risk of issues with insulin sensitivity and blood sugar regulation. Based on your body type, inherited patterns, health challenges and health goals it may be appropriate at times to fast longer for a number of days per week. Periodic fasts of 24, 48 or even 72 hours throughout the year may also be helpful in certain situations. Keep in mind that woman tend to be more sensitive to carbohydrate restriction and fasting, and depending on their genetics and body type may not find these approaches helpful for them. In general, women should avoid fasting and carbohydrate restriction in the ten days before their next cycle.

For an interesting take on the news about adverse health outcomes related to fasting more than 16 hours per day you can refer to this commentary by Dr. Peter Attia a medical doctor whose work focuses on longevity. I share also the perspective of Dr. Sara Ballantye PhD, whose work focuses on optimal nutrition and nourishment. You can find her commentary on Instagram HERE or on Facebook HERE. She also shares an interesting explanation of the term “all cause mortality” HERE.

In the meantime, listen to your body. Avoid extremes. Focus on optimal nourishment and optimal intake of nutrient dense foods. Avoid intermittent fasting and fasting beyond 12 hours if you tend to deficiency, tend to be thin and wiry, have a history of disordered eating or engage in fasting for issues related to body image.