What is intermittent fasting? Depends on who you ask. Here’s my best attempt to provide a definition that satisfies academic researchers and practical influencers like Ed Pierini – intermittent fasting is a lifestyle / diet regimen that involves cycling between long periods of fasting (e.g. 16 hours with only water) and short periods of eating. It falls under the Keto diet umbrella, though I’m sure that description will annoy at least a few practitioners. In this post, I won’t dive into biochemistry or physiology, but instead describe how intermittent fasting can have positive impact on health in our communities.
Why should you care? To put it simply, intermittent fasting delivers results. We’ve all seen many success stories scattered across the internet, and for those of you who prefer expert advice, here is a recent study published in the New England Journal of Medicine. Now let’s dig into the benefits – there is of course the weight loss, which is pretty consistent among those who faithfully take up fasting; losing about a pound per week. I’ve witnessed this rate of weight loss in 3 friends – and 1 wife 😊 – who’ve collectively shed 200 pounds. The real kicker is that all of them struggled with weight loss for YEARS, religiously counting calories and not really losing weight; or at least I couldn’t tell.
Here is the profile for my friend who dropped 100+ pounds through intermittent fasting – he now spends a good portion of his time helping others achieve healthier lifestyles.
My wife had so much success with fasting, she is now eating guilt-free. Trust me, that’s a big deal for her! Those of us who never had weight issues simply don’t understand how challenging that is; especially for women. And her confidence is something else these days; a much better version of herself. So intermittent fasting works. Period. Finally, there are other VERY important health benefits associated with intermittent fasting, which include a longer lifespan and lower chances of developing chronic diseases. Again, check out the NEJM article linked above (unfortunately, behind a paywall).
The first time I heard of intermittent fasting, my immediate thought was this would never catch on. It requires too much willpower to go 18 hours a day with nothing but water. But one by one, my friends went for it, and made a full lifestyle change to accommodate the fasting. This includes eating carefully during the “eating window” – very few carbs, plenty of vegetables and protein – and regular exercise. What happened to them was a domino effect. One friend kicked this off, demonstrated good results, and others followed. That’s the network effect. There are so many diets out there, beautifully advertised; but nothing hits home like seeing your friend rock a brand new body. Even celebrities don’t have that kind of influence, and many of them have already jumped on the intermittent fasting wagon.
Can intermittent fasting be scaled? Here is the part that truly piques my interest, because I am a “systems” guy. Is intermittent fasting for everyone? Can we safely scale (promote) intermittent fasting across a diverse population? A key aim of population health, especially in the Medicare space, is to reduce healthcare utilization and spending through good management of chronic disease. If you’re not familiar with population health, please give this a read. So the question is whether intermittent fasting can be used in population health management. In particular, can older people (> 50 years) realistically perform this type of fasting, lose excess weight, and achieve better health outcomes down the road?
Well, there are two ways to go about answering this question: 1) pose this question to physicians; and 2) find examples of older people who have success with fasting (Halle Berry is one example). I can’t imagine physicians suggesting elderly diabetics adopt a rigorous fasting routine. But what about older pre-diabetics who are overweight? There is probably some segment of the older “at-risk” population that can adopt and benefit from intermittent fasting. And as always, nothing speaks louder than success – circling back to Ed Peirini’s long experience with intermittent fasting.
And then there is the other elephant in the room – how to actually convince overweight people to adopt intermittent fasting. In population health, we refer to this “persuasion activity” as patient engagement, and it’s one of the hardest things to do.
Influencing people to adopt positive lifestyle changes is a challenge, but I do know one thing: in order to convince anyone to do anything, you should have direct experience with the method you’re pushing. Case in point: I live one block away from a major hospital, and I can’t tell you how often I see overweight doctors and nurses taking cigarette breaks. Honestly, I don’t know how these people are supposed to convince others to adopt healthy lifestyles! They cannot.
~ James
We’re a couple of trailing-edge baby boomers writing at our blog, Aging With Freedom. (Age 61 and 59.) We adopted intermittent fasting this last year. Using the daily 8-hours eating window/16-hours fasting model. https://agingwithfreedom.com/2019/09/17/lifespan-by-david-sinclair/ (We’ll add your article as a supplement to ours as it’s on-point. Happy to collaborate further.)
We were influenced by Dr. Peter Attia, Dr. David Sinclair, and others. Thought it was worth an experiment.
Our primary motivation was more healthy longevity and brain defense. But we see definite weight loss benefits.
Each of us moved down off of long-term weight set points. With no particular trouble. We’ve done 48-hour fasts about once a quarter. We haven’t quite managed to go 72-hours. But to go from 5:30-6:00 pm dinner to after 10:00 am without eating is our primary reform. Along with the complementary reduction of sugars and carbs. We’re not perfect adherents either.
We thought it would be harder than it is. We both grew up with three squares a day, loving breakfast. With coffee in the morning, we’re really not desperate when it comes time to literally “break fast.” Often go to Noon without really noticing the time or hunger.
I’m male, 6’1″, peak weight was 228 lbs. Down to 192 (headed to 185 and normal BMI). My wife is 5’8″ down to 145 lbs from 160ish. She’s within 10 lbs of her slender college weight. I’m about 30 lbs above college weight. We both have desk-centric professional careers. So exercise is leisure time not work time. We exercise. Primarily dog walking and stretching. An active dog is a good disciplinarian. But the weight loss is a function of regulating how often and when we eat. And not counting calories or a new exercise routine.
Excellent to see the details on your experience with implementing intermittent fasting. This is unexpected but I keep hearing from IF practitioners that actually starting (and maintaining) the fasting routine was not very difficult. That suggests there are certain common benefits, i.e. feeling good, that are immediate, which cancels the need for excessive willpower. Again, the details around your experiences are valuable and I hope/encourage others to share and share freely. I look forward to keeping in touch with you regarding this important topic!:)
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