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.
Fasting on keto can be incredibly beneficial, especially if you’ve reached a plateau and aren’t seeing results from the ketogenic diet alone. While it’s not required, keto intermittent fasting can bring the benefits of your diet to the next level and help optimize your health. It is also thought to speed up ketosis by helping your body burn through glycogen stores more quickly, which can help sidestep symptoms of the keto flu to get faster results.

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Autophagy is spring cleaning for your cells. It’s Latin for “self-eating,” which is spot-on: when autophagy turns on, your cells sift through their internal parts, get rid of anything that’s damaged or old, and install shiny new versions.[8] Autophagy is like a tune-up for your car: afterward everything runs more smoothly. It reduces inflammation and even boosts longevity. Intermittent fasting triggers, to quote researchers, “profound” autophagy, especially in your brain.[9]
Expect funny looks if you spend a lot of mornings with breakfast eaters.  A few weeks back I had a number of friends staying with me, and they were all completely dumbfounded when I told them I didn’t eat breakfast anymore. I tried to explain it to them but received a bunch of blank stares. Breakfast has become so enGRAINed (zing!) in our culture that NOT eating it sounds crazy.  You will get weird looks from those around you…embrace it. I still go to brunch or sit with friends, I just drink black coffee and enjoy conversation.
No cravings. Fat doesn’t spike your blood sugar levels. In fact, a keto diet is so effective at stabilizing blood sugar that it got type II diabetics off their medication entirely, according to a recent study.[15] If you pair a keto diet with fasting, your blood sugar will stay stable and low (but not too low) all day. Say goodbye to the cravings, fatigue, and mood swings that make high-carb fasting so difficult.

You’ll spike your blood sugar when you eat. If you’re fasting on a high-carb diet and you’ve powered through the cravings and lack of energy from low blood sugar, there’s a good chance you’ll eat a ton of carbs when you feast. You want to eat big meals when you fast to make sure you’re getting enough calories, but all those excess carbs in one go will spike your blood sugar in the opposite direction, from low to high.[14] High blood sugar causes fatigue and lack of focus. That raging hunger will also cause you to binge unnecessarily, and whatever carbs you don’t use will get stored as fat.

Keep these studies in mind as your body tries to play tricks on you during your first day of fasting.  Even after three days of fasting, health complications are highly unlikely. However, it is important to know about the possible issues that can be caused by fasting. If you choose to incorporate fasting into your daily diet, you typically want to eat every day as well. Occasionally going on a longer period of fasting.
On the flip side of that, eating keto can make your periods of fasting more manageable. For example, someone who is eating a diet higher in carbs will likely have more discomfort with intermittent fasting as the body constantly switches between glucose for fuel and ketones for fuel. By continuing to eat keto even during feeding periods, you can keep your body constantly running on ketones.
Eat one large meal per day, cutting out all other meals and snacks. For those who aren’t interested in checking clocks and calendars, this is probably the easiest option. This is also a good choice for busy individuals who have a lot going on during the day. Just skip breakfast and lunch and have a large dinner that will carry you over through until bedtime.
Two ground-breaking studies have recently been published on the effects of intermittent fasting on males. One group of researchers studied the effects that 16 hours of intermittent fasting had on males that lift weights. They found that muscle mass stayed the same, fat mass decreased significantly, and the males who fasted for 16 hours a day burned more fat for fuel compared to the control group that only fasted for 12 hours.
A 2018 review of intermittent fasting in obese people showed that reducing calorie intake one to six days per week over at least 12 weeks was effective for reducing body weight on an average of 7 kilograms (15 lb); the results were not different from a simple calorie restricted diet, and the clinical trials reviewed were run mostly on middle-aged women from the US and the UK, limiting interpretation of the results.[25] Intermittent fasting has not been studied in children, the elderly, or underweight people, and could be harmful in these populations.[25][26]
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.
In Prime Women’s recently launched PLATE weight management program, Dr. Kathryn Waldrep recommends eating within a nine hour window and choosing that time frame based on your body’s circadian rhythms. Early risers might eat between 9:00 am and 6:00 pm. Night owls would eat their first meal at noon and finish their last meal at 9:00 in the evening. As more and more research has been done around IF and circadian rhythms, there seems to be more and more evidence on the soundness of this approach to eating for weight management.
Intermittent fasting isn't a regimen built around limiting calories (although it's likely that your calorie intake will be restricted naturally since you're going a period of time without eating), but it can promote weight loss in a big way. Fasting gives your metabolism an overhaul. It works on the same principles as a ketogenic diet. By restricting food (and carbohydrates), you'll switch your body from burning glucose for energy to burning stored body fat.
Fill your plate with plenty of healthy fats, such as coconut oil, avocados, olive oil, ghee and grass-fed butter as well as moderate amounts of protein foods like grass-fed meat, free-range poultry, fatty fish and eggs. Non-starchy vegetables, fresh herbs, nuts, seeds and healthy beverages like water, bone broth and green tea can all be enjoyed as well.
On this plan you'll eat clean five days of the week but will not eat anything for two nonconsecutive days of the week. For example, you can fast on Monday and Thursday but eat clean meals on the other days. Food on these five days will look just like the rest of the fasting plans—healthy fats, clean meat sources, vegetables, and some fruit. Keep in mind that this plan is not for beginners, and you should always talk to your doctor before starting any fasting regimen, especially if you are on medication or have a medical condition.
There’s a ton of incredibly promising intermittent fasting (IF) research done on fat rats. They lose weight, their blood pressure, cholesterol, and blood sugars improve… but they’re rats. Studies in humans, almost across the board, have shown that IF is safe and incredibly effective, but really no more effective than any other diet. In addition, many people find it difficult to fast.
I’ve read several places that adding gelatin or collagen to coffee breaks the fast, but I don’t understand why since there are no carbs, only protein, and fewer than 50 calories per tablespoon. Have you tested this? It would be great to be able to add protein to my morning coffee so I would love to know. Would also love to know if one tablespoon of coconut cream affects ketones and glucose.
This content is strictly the opinion of Dr. Josh Axe and is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Dr. Axe nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.

The 5:2 diet, also known as the “Fast Diet,” involves restricting calories two days a week to 500 calories per day (with two 250 calorie meals), while eating normally for the other five days. For example, you might eat all of your regular meals Saturday through Wednesday, and eat 500 calories per day on Thursdays and Fridays.There isn’t a ton of research to back up this diet, although it was publicized by Michael Mosley, a British journalist and doctor. Since it doesn’t completely restrict food on the fasting days, it may also be an effective way to ease into fasting without shocking your system. The Fast Diet is considered safe for men and women.
Every diet plan that has ever produced results is, at its heart, a strategy for lowering calorie intake. All-fat, no-fat, reduced-carbs, gluten-free, paleo… they may all take different approaches to weight loss, but they all have the same result. By limiting food intake, or even just limiting food options, these diets reduce our calorie consumption. And when calorie intake drops below calorie burn, that’s when we start to drop the pounds.
Zero-calorie beverages are okay.  I drink green tea in the morning for my caffeine kick while writing. If you want to drink water, black coffee, or tea during your fasted period, that’s okay.  Remember, don’t overthink it – keep things simple! Dr. Rhonda Patrick over at FoundMyFitness believes that a fast should stop at the first consumption of anything other than water, so experiment yourself and see how your body responds.
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