It's been a while...a lot has happened since March.
I asked my girlfriend to marry me on March 29th.
We just purchased our first home.
All that to say, I apologize for the silence since March-April, but I am hoping late 2024 to early 2025 will lend itself to being able to post more.
- - -
One of my closest partners, Jonathan Brawley at Lake Norman Fitness Specialists recently proposed having me periodically answer some nutrition questions for his clients. Below, you'll find some great questions & answers on topics like intermittent fasting, greens powders, and some new snack ideas.
- - -
“What are your thoughts on intermittent fasting (IF) for fat loss and overall health?”
I don’t build my plans based on intermittent fasting (IF), but I am secretly a fan. Logistically, I find these to be the main “Boots on the Ground” benefits:
-You have a clear window of time when you’re “allowed to eat”, and when you’re not. People often think about things in “black and white” terms, so that polarity can make adherence easier, especially if mindless/emotional snacking is a challenge.
-You don’t have to worry about cooking/eating during the day; you can fast around times when you’re busiest, and eat when you have time for it. This is nice because if you’re a surgeon or a pilot, time can be short and eating lunch on a schedule might not always be feasible.
-Many people think “in order to succeed, you have to suffer”; in these terms, another appealing factor of intermittent fasting is that one will feel hunger most of the day, which makes people feel like they’re making a sacrifice. Like they’re doing something for themselves; this discomfort can be motivating, for some.
-Concurrent with extended fasting is an increase in sympathetic (“fight or flight”) hormones such as cortisol, and epinephrine; these endocrine changes can acutely increase focus, as many “fasted lifters” claim.
-Then, on the other side of that fast/sacrifice is often a big meal, which can be exciting. Think: If you need 3,200 calories per day, you might also be required to eat very fatty/starchy meals within your eating window to hit your macros. [Dopamine]
There’s a lot to like about intermittent fasting, but my major concerns:
1.) We don’t know everything about nutrient absorption. The field of nutrition, today, is analogously where surgery was in the 1700s. Is it possible that getting all of your protein in one sitting is negatively affecting bottom line absorption, and utilization of those amino acids? Could certain micronutrients not be utilized properly as a result of getting all of those nutrients in a 4-hour window? I’m not convinced, but we cannot rule it out; we see similar phenomena in the small intestine in terms of amino acid absorption. In my experience, evenly allocating nutrients over the day makes the most sense, and the evidence does seem to agree.
2.) What regimen are we following? Are we doing a “Warrior Diet” with a 20 hour fast and 4 hour eating window? Or alternate day fasting? The evidence around fasting is still fuzzy, largely because there are so many flavors of intermittent fasting. It’s not enough to say “Is intermittent fasting is good or bad?” but we also have to figure out “Which variety is best?”
3.) What is the effect of fasting on your consciousness? Are you fasting while you’re working a job on your feet all day? Or maybe you’re going into a workout fasted, you get tired, and fall/hit your head on some plates. Many don’t consider that hypoglycemia (“low blood sugar”) is acutely more dangerous then hyperglycemia (“high blood sugar”); fasting is a good way to reduce blood sugar, but it’s possible to get more than we bargained for.
4.) What are the long-term effects of following this lifestyle? I am not arguing it’s all bad; I think there are practical benefits, and I’ve seen progress in people that I personally know. However, IF can be a relatively “radical” regimen; not many people fast that long on a regular basis, and/or eat all of their calories in such a tight window. As such, the evidence around this eating style is, in my professional opinion, not where it needs to be for me to recommend it to my patients/clients.
These are my practical questions/concerns. Again, I am not referring to the literature here; the papers are out there. I am purely sharing my unique “Boots on the Ground” experience as a dietitian.
Alternatively, I am aware of a study that was published this month [March 2024] discussing how intermittent fasting is associated with increased risk of cardiovascular disease. I’ve seen some claim that intermittent fasting can negatively affect the function of the thyroid. However, there’s also evidence suggesting that intermittent fasting can improve body fat loss compared to a standard 3-meal/day regimen. Some evidence exists demonstrating reduced cardiovascular disease risk, and that IF can even reverse diabetes in certain populations. These are valid questions, and more research should be done to answer them.
TL;DR: IF can work but be careful with choosing your regimen, and specifically how it relates to periods of activity. Don’t workout fasted for the first time with no one around, or with 1RM attempts on big compound lifts. My biggest acute concern is hypoglycemia. Long-term concerns/benefits are still being determined, and I am not confident in the data, at this point. Ultimately, the most important things:
1.) Are you training with resistance at least twice a week?
2.) Are you sleeping at least seven hours, and on a regular schedule?
3.) Are you consuming adequate calories/macros, and water?
4.) Are you internally managing your stress?
At the end of the day, if you do these things, regardless of regimen you’re likely to see results.
------------
“With all of the conflicting information out there, how do I know what to do? One day fasting is good, next day it's bad. Carbs are the devil, carbs are good for you. High fat vs low fat. Dairy is bad for you, dairy is good for you.”
This is one of the most common concerns I run into with my clients: “Paralysis by analysis”. There’s so much information, who’s right? The only way to know the answer to all of these questions is to pursue formalized education & use that information to experiment on yourself, or to work with a professional who has already received that experience/education.
On your specific points, I will say:
-To pursue intermittent fasting every day is not advisable based on the current evidence and my experience working with people over the last 10 years. Does it work for people? Absolutely. It worked for me. But I’m not convinced it’s the most efficient, or the safest way.
-There are three main types of carbohydrates; I will assume you’re referring to starch. Starch is not only NOT bad, but one of the most important nutrients to consume to maintain thyroid health into mid-life and onward. PLEASE DO NOT CUT OUT STARCH; I will go as far to say I believe the promotion of low-carbohydrate diet is one of the most well-orchestrated conspiracies of the 21st century.
-I’m not sure if what’s meant here is “high fat macronutrient ratios”, or “choosing high fat dairy vs. low fat dairy”. Regardless, I typically aim to get 25-30% of calories from fat or oil. Usually I opt for reduced fat, part-skim, or 1% dairy products.
-Dairy is fine unless someone has a sensitivity, intolerance to a dairy component (casein, whey, certain peptides), or is lactose intolerant. Other than that, dairy is getting a bad wrap these days, and I don’t entirely understand why.
------------
“Do I actually need to take a multi-vitamin? What vitamins should I take?”
I would advise a multivitamin for the following people, or any combination:
-Someone who cannot eat [> 4 cups of veggies] + [> 3 cups of fruit] each day
-Someone who doesn’t eat fish/meat/dairy
-Anyone who generally struggles to eat enough food (i.e. someone with unusually low appetite)
-Anyone who is a high-performance athlete should probably supplement with MVI
If you fall into any of these categories, the MVI I recommend these days is “Rainbow Light”.
“Are greens powder actually good for you?”
They can be! It really depends on the source; with this class of supplementation, my biggest concern is heavy metal contamination. My favorite powder, based on third party testing, is going to be Balance of Nature.
“Should I avoid meals that have moderately high fats and carbs together?”
I actually advise my clients to include a source of starch, protein, and fat at each meal, bare minimum; I’ve even devised an acronym for it: SPF.
------------
“What are some of your recommended snacks?”
Veggie (Cucumber/Tomatoes) + Balsamic/Apple Cider Vinegar; maybe a bit of feta cheese!
Catalina Crunch Cereal
Wyman’s Fruit Cups
That’s It Fruit Bars
LS Cottage Cheese with [Cucumber/Pepper] or [Peaches/Pineapple]
Jeff’s Low Sodium Beef Jerky
Halo Top Ice Cream
Got some really great questions this time; I'm already looking forward to seeing what you can come up with for next time.
In Good Health,
Tim Smith MS, RD, LDN
Comments