Intermittent Fasting 101

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Everything you need to know to get started
Michael Lara, MD

Medical Disclaimer
The information presented in this seminar is for informational purposes only. It is not intended to diagnose or treat any medical problems. Please consult with your health care professional before making any changes to your care plan. Michael Lara, MD disclaims all responsibility for any liability, loss or risk, personal or otherwise, that is incurred as a consequence, indirectly or directly, of the use and application of the information in this webinar. Michael Lara, MD and associates do NOT have any financial affiliations with any of the products mentioned in this webinar.

Why Intermittent Fasting?
“Food For Thought: How Nutrients Affect the Brain” 12 cities 3,000 participants Most popular topic in 6 hour seminar: Intermittent Fasting

Story of C.M.
Married, mother of 3 children Struggled with weight gain most of her life Diets failed Fatigue Exercise failed Flare-ups of rosacea and irritable bowel syndrome

December 2010

March 2012

How C.M. Transformed Herself
Intermittent fasting Key nutrients Strategically-timed exercise

What Is Intermittent Fasting?
Intermittent fasting (IF) is a pattern of eating that alternates between pre-determined and strategicallytimed periods of fasting and non-fasting Alternative to continuous caloric restriction or other diets based on nutrient composition Focus is on when to eat; not on what to eat Timing of meals optimizes how our bodies were evolved to metabolize nutrients

Benefits of Intermittent Fasting
Reduced Blood pressure Blood lipids Inflammation Increased Fat burning Growth Hormone Metabolic rate Improved Appetite Blood sugar Neurogenesis

Variants of IF
Alternate day fasting (36 hour fast/12 hour feed) Meal-skipping (Random) Eat Stop Eat (24 hour fast, 1 or 2 times per week) Leangains (16 hour fast/8 hour feed) Warrior Diet (20 hour fast/4 hour feed)

Example of IF Protocol
Induction Phase: 2 weeks Limit meals to one 8-hour window (Noon-8:00 pm) Maintenance Phase Limit meals to one 4-hour window (6:00 pm-10:00 pm) During fasting, may consume coffee, green tea, fiber, or branched-chain amino acids

What to eat during a feeding window
Generally, diets with a higher percentage of macronutrients coming from protein and fat are preferred during periods of caloric restriction

De Souza, “Alternatives For Macronutirent Intake and Chronic Disease ”, The American Journal of Clinical Nutrition, July 2008.

Key Nutrients for IF
Fiber: 3-5 grams twice daily Healthy fats Omega-3 fatty acids: 2 grams twice daily Medium-chain triglycerides: 15 grams twice daily Branched-chain amino acids: 10-15 grams twice daily

Fiber and Intermittent Fasting
Slows absorption of glucose Contributes to sensation of fullness (via gut hormones GIP and GLP) Sources: Psyllium husk (Metamucil) Methylcellulose (Citricel) Take 3-5 grams twice daily

Healthy Fats
Omega-3 Fatty Acids (Fish Oil): 2 grams twice daily Medium-Chain Triglycerides (Coconut Oil): 15 grams twice daily; preferably at beginning and end of fast Healthy fats will accentuate benefits of IF by: Inducing production of ketones, used as alternative energy source by brain and muscle Reducing hunger Improving mood and cognition

Branched-Chain Amino Acids
Essential amino acids leucine, isoleucine and valine BCAAs maintain muscle mass while dieting BCAAs reduce hunger and balance blood sugar Precursors to gluconeogenic glutamine and alanine BCAAs “may cause weight loss through signalling mechanisms to brain and adipose tissue”

Exercise and Weight Loss
In long-run exercise alone is not effective for long-term weight management Increases compensatory eating and reduction in daytime activity Increases stress hormone cortisol Likely to lead to repetitive-use injuries Exercise during induction phase of IF: Leisurely walks of 30-60 minutes/day Exercise during maintenance phase of IF: Daily walks AND resistance-training 2-3 times per week

Role of Resistance-Training
Preserves muscle mass during periods of caloric restriction Improvements in lean body mass associated with improved blood glucose Increases Growth Hormone induced by IF

Effects of Resistance-Training v. Aerobic Training on LBM
LBM is lost and RMR is decreased when diet is combined with aerobic-training

LBM is preserved and RMR is increased when diet is combined with resistance-training

Bryner, “Effects of Resistance vs. Aerobic Training Combined with an 800 Calorie Liquid Diet on Lean Body Mass and Resting Metabolic Rate”, Journal of The Americal College of Nutrition, 1999.

Strategically-Timed Exercise
Exercising in such a way as to optimize hormonal and anti-inflammatory effects of intermittent fasting Leisurely walks done during fasting periods to reduce cortisol Resistance training done toward the end of the fasting periods to increase growth hormone and increase glucose sensitivity of muscle tissue

Summary
Intermittent fasting associated with multiple health benefits Blood glucose, growth hormone, fatty acid oxidation Health benefits are optimized when intermittent fasting combined with: Key nutrients (fiber, healthy fats, BCAAs) Strategically-timed exercise (leisurely walks and/or resistance training)

When diet is wrong medicine is of no use; When diet is correct medicine is of no need.
~Ayurvedic Proverb

Next Steps
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