Intermittent Fasting
My initial thoughts on fasting when reading about cognitive health was a resounding “yeah, right.” I love to eat and couldn’t fathom going 12-16 hours without food every day, as recommended by Dale Bredesen, M.D., in “The End of Alzheimer’s
I never thought I would succeed because for so many years I had been so firmly entrenched in the need to eat every three to four hours thanks to my crazy blood sugar issues. Although I had gotten my blood sugar under control by the time I had read Perlmutter’s and Bredesen’s books, I was still afraid that all-too-familiar feeling of shaky faintness brought on by low blood sugar would return if I went too long without food. I also wondered about the common belief that skipping meals is unhealthy and fasting would put the body into “starvation mode” and result in fat retention. Americans for years have been browbeat about the importance of eating regularly and not skipping meals, especially breakfast – the most important meal of the day. Could the mainstream health experts have been wrong about this? According to Mark Sisson, author of “The New Primal Blueprint
“This is only true,” he writes about fasting being the healthier option, “if and only if you are fat-adapted and able to access internal sources of energy. If you are carb-dependent and you force yourself to fast, skip meals, or try a restrictive calorie diet, your body will shift into starvation mode. … The only way to break free is to moderate insulin production in your diet, thereby reprogramming your genes to burn stored body fat. Once fat-adapted you can drop excess body fat through strategic fasting and calorie restriction, without the risks that arise when you are carb-dependent.”
In other words, those who follow a ketogenic diet – high fat/moderate protein/low carb – benefit from fasting, while those who subscribe to the high carb, low fat Standard American Diet add insult to injury when they fast or skip a meal. Sisson goes on to say the body needs about three weeks of “devoted dietary modification” to fully adjust from carb-burning to fat-burning, so people should stick with it and make sure they are fully adjusted before beginning a fasting regime.
For Bredesen’s ketogenic/flexitarian diet, Ketoflex12/3, presented as part of his ReCODE protocol to prevent Alzheimer’s, the 12/3 refers to intermittent fasting: ensure at least 12 hours between your last meal of the day and breakfast and make sure you finish your last meal of the day at least three hours before bedtime. He says this is a highly effective way to induce ketosis and improve insulin sensitivity, which improves cognition. Ensuring no food for at least three hours before bedtime prevents blood sugar (and the resulting insulin) from spiking just before bedtime, which contributes to insulin resistance and inhibits the production of melatonin and growth hormone, “which aid in sleep and immune function, as well as repair.”
“Another big benefit of fasting for 12-16 hours,” Bredesen continues, “is that it promotes autophagy, in which cells (including those in the brain) recycle components and destroy damaged proteins [such as the infamous amyloid beta proteins, which are produced from cut amyloid precursor protein!] and mitochondria – which is good for renewal.”
For people with the Alzheimer’s gene, ApoE4, (yours truly), Bredesen recommends fasting from 14-16 hours between supper and breakfast to better optimize all the above-mentioned benefits. I decided to tackle the 14-hour minimum even before I knew for sure I had the gene, figuring better to err on the side of caution. Just as I did with sugar, I told myself, no pressure. I refused to make myself go hungry. I would try pushing back my breakfast, but I wouldn’t force it. I really didn’t believe I would be able to delay my beloved breakfast green/protein smoothie (more on this and my journey in finding the perfect breakfast in the near future!) for that many hours.
I’ve known many people who are just not breakfast eaters. They have their cup of coffee in the morning and are fine until lunch or perhaps a small mid-morning snack. That was never me. I’ve always eaten breakfast within an hour of waking up. This, in adulthood at least, was done out of necessity because my out-of-control blood sugar and insulin resistance wouldn’t allow for anything else. But even after eliminating my insulin resistance and becoming fat-adjusted on the keto diet, I still ate first thing. The regular meal routine was so ingrained in me that I continued out of habit and not out of hunger (I never realized I wasn’t hungry that early until after I started fasting.) Sisson says if people who are adjusted to the keto diet pay attention and eat only when they are hungry and not just because the clock says it’s lunchtime, they will find themselves naturally eating fewer times in a day and less food with each meal. He’s right.
I mentioned in my post on sugar that I had refused to ever let myself go hungry or deprive myself of food, and I continued that promise when I began intermittent fasting. On day one, I made sure I was done eating for the day (this does not include water) by 7 p.m. Bredesen recommends breaking your fast with lemon water (room temperature or warm water, not cold). The lemon serves as a detoxifier while providing a shot of vitamin C. So the next morning, I woke up at my usual 5 a.m., packed my smoothie and a 20-ounce bottle of water with the juice squeezed from half a lemon along with my lunch and headed to work, arriving at 7 a.m.
To my astonishment, I didn’t start to feel any hunger pangs until about 8 a.m. I had made it 13 hours on my first day without sacrificing at all. So I broke my fast then with the lemon water. This was surprisingly satisfying, refreshing and even invigorating, and it easily tied me over until I enjoyed my smoothie at 9:30 a.m. I decided to continue this schedule, which lasted a week or two, but then to my continued surprise, I started taking longer and longer to finish the lemon water, (work keeping me busy and no hunger pangs distracting me or nagging at me to eat) which pushed back the time I would drink my smoothie. My body seemed to transition into intermittent fasting without my even trying and in no time I was drinking my lemon water after 9 a.m. and my smoothie after 11 a.m. I had reached Bredesen’s 14-hour recommendation with ease.
Then at the start of September, just a few weeks ago, my work schedule changed to second shift (2-10:30 p.m.) and I had to rethink my whole day. It turns out the change in hours actually improved my eating schedule. Prior to my new work hours I would eat lunch within an hour or two of drinking my smoothie. Again, I was eating lunch not because I was hungry but because I believed I needed to eat. I thought if I ate a late lunch, I wouldn’t be hungry for supper, which needed to be eaten fairly early to begin my fast on time. But after my schedule change, things actually got much easier. Waking up later pushed my breakfast later, and going into work at 2 p.m. made it difficult to eat lunch earlier than 3. At first I tried to eat at around 3 but thought “what am I doing? I’m not hungry yet!” I now drink my lemon water after 10 a.m. and my smoothie after noon, eat dinner at around 4 p.m. and then a small meal/snack usually consisting of nuts, organic dark chocolate (80 percent cacao or higher) and/or some fruit and a caffeine-free herbal tea at around 7 p.m. I then begin my next fast at 8 p.m.
This has worked incredibly well for me, and I have never felt deprived or hungry. Introducing intermittent fasting into my daily routine helped me to wake up to just how much I was needlessly eating. I’ve said many times previously that people should get to know their bodies and listen to what their bodies are telling them to find true health. The same goes for hunger. If you embrace a keto diet and abandon the belief that meals must be eaten regularly (I actually found it very difficult letting go of this as I have always been – and still am – a very routine-oriented person) it can be very liberating because suddenly your life doesn’t revolve around when you’re going to eat next.
“When your body has reprogrammed gene expression to be able to get energy from fat whenever it wants, hunger tends to subside, and blood sugar and energy levels stabilize,” Sisson writes in “The New Primal Blueprint
Sisson and Bredesen both provide a list of health benefits to intermittent fasting, ranging from weight-loss and improved insulin sensitivity to reduced inflammation and oxidative damage (more on this in the future) and improved cognitive function. And in my experience, they are absolutely right. I have felt fantastic since adopting my fasting plan (not to mention some additional weight-loss), and as I continue to adjust, I can see myself easily transitioning from a 14-hour fast to a 16-hour fast. I’ve said giving up gluten and added sugar were the best things I’ve ever done for my health. Well, introducing intermittent fasting comes in a very close third.