Amy Shah, MD, is double board-certified doctor who received her medical training from Cornell, Harvard and Columbia Universities. She has a thriving medical practice in the Phoenix area, where she sees more than 5,000 patients each year. In 2015, Dr. Shah was named one of the “Top 100 Women in Wellness to Watch” by MindBodyGreen and was a guest on the Dr. Oz show.
To start, recognize that the bulk of your weight-loss is going to come from fasting, not from working out. Exercise will have other benefits, of course, like building and preserving muscle tissue, improving performance, and increasing endurance, but it won’t be where you’re really taking off the pounds. With this in mind, if your priority is to lose weight, you’ll need to be prioritizing meal planning over working out. As you start intermittent fasting, you may need to pull back from regular strenuous exercise, at least until you feel like your body is used to your new schedule.
I started IT about 6 weeks ago. I eat between 12 noon and 8 pm. This works best for me and I have found easily sustainable. The results so far have blown my mind. I have an autoimmune disease and struggled with bloating, multiple food intolerance, gut pain, frequent urination, sugar cravings. All of these symptoms are gone. My hunger is controlled and I can enjoy lovely family dinners again. I think ideally eating earlier in the day would be better, but due to my schedule this works better for me and I am happy with the results.
So, what exactly is a relaxed approach to intermittent fasting? Again, since there’s little research done on intermittent fasting, we’re dealing with a bit of a gray area. The opinions also tend to vary depending on which site you visit, or which health expert you ask. From what we’ve found, the general guidelines to brief intermittent fasting for women are:
Forms of intermittent fasting exist in religious practices in various groups across the world. Religious fasting regimens include, but are not limited to, Vrata in Hinduism, Ramadan fasting (Islam), Yom Kippur fasting (Judaism), Orthodox Christian fasting, Fast Sunday (The Church of Jesus Christ of Latter-day Saints), and Buddhist fasting. Certain religious fasting practices, like Buddhist fasting, only require abstinence from certain foods, while others, like the Jewish fast on Yom Kippur, last for a short period of time and would cause negligible effects on the body.
Before the Nobel Prize was awarded to Yoshinori Ohsumi, other researchers were making groundbreaking discoveries about autophagy. In 2009, an article was published in Cell Metabolism entitled Autophagy Is Required to Maintain Muscle Mass. In this article, researchers described how deactivating an important autophagy gene resulted in a profound loss in muscle mass and strength.
You’ll run out of energy. When you don’t have anything in your system for several hours, your blood sugar will eventually drop below baseline. If you’ve ever had a blood sugar crash, you know how this state feels. Sleepiness, trouble focusing, lightheadedness, intense cravings, and the occasional mood swing typically accompany low blood sugar. Your cells run low on fuel and they start demanding that you give them more carbs.
After determining your preferred protocol of intermittent fasting, you should start planning out your diet for the days that you do eat. On a standard keto diet, 75 percent of total calories should come from fat, 20 percent should be from protein and 5 percent should come from carbs. When getting started, however, you can start with a modified keto diet instead, which is often considered more flexible and easy-to-follow. With this diet plan, about 40–60 percent of calories should come from healthy keto fats with 20–30 percent from protein foods and 15–25 percent from carbohydrates.
Although there's no specific dietary recommendation when intermittent fasting, many people choose to combine it with a low-carb, ketogenic diet. When it's time to eat, include foods that are high in good fats and low in carbohydrates. That means eating nuts, seeds, vegetables, avocado, olives, meat and fish, while avoiding whole grains, fruits, starchy vegetables, sugary drinks and anything processed.
As a lifestyle-leaning research doctor, I needed to understand the science. The Obesity Code seemed the most evidence-based summary resource, and I loved it. Fung successfully combines plenty of research, his clinical experience, and sensible nutrition advice, and also addresses the socioeconomic forces conspiring to make us fat. He is very clear that we should eat more fruits and veggies, fiber, healthy protein, and fats, and avoid sugar, refined grains, processed foods, and for God’s sake, stop snacking. Check, check, check, I agree. The only part that was still questionable in my mind was the intermittent fasting part.
In fact, the authors of this book said that they had patients who only changed their eating habits with this twelve- to sixteen-hour “fruit” fast each day. They did not follow the diet’s other rules or count calories, and they still lost weight and got healthier. This strategy might have simply worked because the dieters replaced junk food with whole foods. In any case, people found this dietary change effective and easy to make. Traditionalists won’t call this fasting; however, it’s important to know that you may have options if you absolutely can’t abstain from food for several hours at a time.
I was very curious about this, so I asked the opinion of metabolic expert Dr. Deborah Wexler, Director of the Massachusetts General Hospital Diabetes Center and associate professor at Harvard Medical School. Here is what she told me. “There is evidence to suggest that the circadian rhythm fasting approach, where meals are restricted to an eight to 10-hour period of the daytime, is effective,” she confirmed, though generally she recommends that people “use an eating approach that works for them and is sustainable to them.”
The four-hour eating window — which Hofmekler refers to as the “overeating” phase — is at night in order to maximize the Parasympathetic Nervous System’s ability to help the body recuperate, promoting calm, relaxation and digestion, while also allowing the body to use the nutrients consumed for repair and growth. Eating at night may also help the body produce hormones and burn fat during the day, according to Hofmekler. During these four hours, the order in which you eat specific food groups matters, too. Hofmelker says to start with veggies, protein and fat. After finishing those groups, only if you are still hungry should you tack on some carbohydrates.
Those studies above, in working with small sample sizes, and different types of fasting than recommended here, would lead me to believe that fasting affects men and women differently, and that many of the weight loss benefits associated with intermittent fasting (that affect insulin and glucose responses) work positively for men and negatively for women.