Answering queries about intermittent fasting
Ever since The Truth about Fasting aired on the ABC’s Catalyst program last week, we’ve all been fielding queries about intermittent fasting from friends, family, clients and other health professionals.
Here are some typical questions:
1. I want to a. improve my metabolic health and /or b. lose weight. Should I try intermittent fasting?
Before anyone commits to changing what and when they eat, we need to make a clinical assessment. Particularly when people are wanting to lose weight.
What is their previous dieting history? What is their relationship with food like? (For example, see Tylka Intuitive Eating Scale and Scoring)
The first step is unpacking their weight history and why they want to lose weight. If they have a long history of yo-yo dieting and a poor relationship with food based on restriction, deprivation and calorie counting, the most appropriate place to start is dealing with this rather than commencing on yet another diet.
2. Can anyone try intermittent fasting?
Camilla Dahl is an APD experienced in managing clients who fast. She advises that fasting is contraindicated in:
- People with a BMI<20
- Children (anyone under 18 years)
- Anyone who is malnourished, has cachexia, advanced heart, liver, or kidney disease
- Women who are pregnant and/or breastfeeding or wanting to be pregnant
- Anyone with a history of anorexia nervosa, binge-purge disorder or an eating disorder
- In people with diabetes, poor awareness of hyperglycaemia or hypoglycaemia
- People who have had diabetic ketoacidosis within the last three months
- People with significant cognitive deficits
- Anyone experiencing an acute illness
The following people will require medical supervision and advice if they decide to try fasting:
- People with type 2 diabetes on insulin or sulphonylureas
- People with type 1 diabetes
- Anyone on prescription medication
3. My diet isn’t great at the moment, should I try intermittent fasting?
Our first step should be to work with our clients to help achieve an improvement in diet quality before manipulating the times they eat.
4. Is intermittent fasting more effective than other diets?
Tim Crowe’s blog The user’s guide to intermittent fasting sums up the evidence for intermittent fasting concisely and concludes: “If it connects with you, you find it works, you feel better for it and you can fit it into your daily life then go for it. But there is a long way to go before there is enough evidence to move intermittent fasting into the mainstream as a first-line approach to lose weight or a viable way to treat many health conditions.”
Education in Nutrition’s presentations on intermittent fasting
EIN has produced several presentations on intermittent fasting. These take a detailed look at the metabolic, hormonal and weight changes related to intermittent fasting and the evidence/research studies that have shaped our understanding of intermittent fasting.
Therapeutic fasting for Type 2 reversal
Intermittent fasting and the circadian clock
Reviewing the evidence on intermittent fasting
Intermittent fasting: case study
Intermittent fasting - an update from the dietitian who created the 5-2diet