
Intermittent fasting works – not only for weight loss but also for heart health - pseudolus
https://www.washingtonpost.com/health/intermittent-fasting-works-for-many--not-only-for-weight-loss-but-also-for-heart-health/2020/06/12/11420c1c-a4d5-11ea-b619-3f9133bbb482_story.html
======
jasonlfunk
My experience with IF has taught me that I’m much better at complete denial,
rather than moderation. So if I want to reduce my caloric intake it works
better for me to say No to everything for 16 hours and only eat for 8, then to
try to just eat less and in moderation all day.

It also applies to carb and other reductions. If I allow myself any bread,
sweets, etc, I will eat too much. It’s easier for me to eat 0, then it is to
only eat a little.

~~~
Roritharr
Same here, years of people telling me drastic diets are "unhealthy" etc. kept
me from playing to my strengths of just doing the extremes for long periods of
time instead of fighting constant urges while balancing them with a moderate
calorie intake.

I think most (healthy) people should try fasting for 5 days to see how your
body responds. It won't kill you, but many people are terrified of the thought
of not eating for 12 hours.

~~~
dorkwood
I once fasted for about a week while suffering an illness that wouldn't let me
keep any food down. I only drank water during that time. To my surprise, after
several days of not eating, my hunger disappeared completely. It was scary,
but also eye-opening. The experience taught me that hunger is not the "you
require food right now in order to survive" signal that everyone thinks it is.

~~~
phonypc
There's an idea out there, no idea how true, that what most first-worlders
call hunger isn't even really hunger. More like withdrawal symptoms from food
addiction. The hunger that comes back when you're really malnourished is much
more painful/compelling. Or so I've heard.

------
AnonC
> How do you start? Agatston told me to start by skipping one meal a day,
> usually breakfast. (Yes, you can have black coffee in the morning, into
> which he adds ghee, a type of clarified butter, and coconut oil to reduce
> hunger pangs. It’s not your typical cup of coffee.)

This may be ok to start with, though black coffee by itself has the ability to
kill hunger without these crutches.

Adding ghee or coconut oil in black coffee means it’s no longer effectively
zero calories, and this is not technically fasting. Same with adding sugar to
it. You can skip breakfast and have black coffee, black or herbal teas and
water — all these are effectively zero calories.

One point this article doesn’t address in the 16:8 scheme is the frequency of
eating within the eight hour eating window. Is it ok to have three meals and
snacks within that window? Should it be two meals with a good gap between
them? I’m sure these variations also determine if it works for weight loss or
other benefits.

Intermittent fasting with 16:8 makes it easier to consume lower calories.
Weight loss typically follows if activity levels are maintained the same or
increased (to compensate for a lower basal metabolic rate).

~~~
BiteCode_dev
> This may be ok to start with, though black coffee by itself has the ability
> to kill hunger without these crutches.

I always wonderered how much ok it really was. Dreaking coffee will activate
some digistive processes, and make the liver work. So you are not exactly
fasting.

I never could find a study comparing with, and without coffee.

~~~
wmeredith
You're still fasting because it doesn't affect your blood sugar. That's why
you can drink black coffee, tea, or water when fasting for surgery.

~~~
BiteCode_dev
I heard this, but I can't find any study measuring the differences seriously.

Fasting has various effect, not all of them are linked to the sugar
consumption.

------
bonoboTP
For years I haven't been eating breakfast long before the IF craze. Mostly out
of laziness. Buying all the ingredients, making sure they don't expire,
preparing the food etc. is quite some time, so I gradually dropped the habit
with no adverse effect. I live alone, but oh boy when people learned that I
don't eat breakfast they'd get so defensive and try to tell me how unhealthy
it was and how I must be underperforming because of that etc... I even got
back to eating breakfast and intellectually felt good that now I'm more of a
healthy normal person who does the socially acceptable normal things.

After all the IF articles I immediately went back to no breakfast with no
guilt.

It's crazy how much of this stuff is in our head. The body is really really
adaptive! If you get used to eating breakfast and suddenly skip it, you will
feel like shit. But that doesn't mean your friend who never eats breakfast
also goes through that every day. Or, if you always wake up at 9 AM, you may
be shocked at those morning people who wake up at 4:30 AM. But probably if you
followed their exact routine incl the evening routine, you'd find after a few
weeks that it's not too bad. Surely there is a genetic component to it as
well, but we underestimate the power of adaption and habits.

And most importantly, don't be so defensive when someone tells you about a
strange habit of theirs while they are visibly healthy and well adjusted.
Eating disorders and sudden drastic changes are of course cause for concern,
but many people have a crabs in the bucket mentality and feel personally
attacked when someone does something for their own health.

~~~
tedmiston
> After all the IF articles I immediately went back to no breakfast with no
> guilt.

> It's crazy how much of this stuff is in our head.

Likewise the idea that "breakfast is the most important meal of the day" being
ingrained in American culture despite lacking a scientific basis [1].

[1]: [https://thefastingmethod.com/tyranny-breakfast-lose-
weight-v...](https://thefastingmethod.com/tyranny-breakfast-lose-weight-v/)

~~~
cutemonster
Maybe breakfast is really important for children so they grow? But I stopped
eating breakfast many years ago me too (before I knew about IF)

------
codernyc16
He lost 45 lbs, that’s what probably removed his sleeps apnea. Not because of
some other magical ability of intermittent fasting. One of my friends also
lost a lot of weight and his apnea went away, he went off of his CPAP machine.

~~~
downerending
You're probably correct, in that losing a lot of weight greatly improved his
health. That said, losing weight is freaking difficult, and if intermittent
fasting is a path towards that, it'd be very useful.

I've done a lot of fasting. The _results_ seem pretty good. Pulling it off is
non-trivial.

At this point, we need "magical", because nothing else has really seemed to
work in general for losing weight.

(And no, didn't read the article, because paywall.)

~~~
tom_mellior
> work in general

That's far from sure at this point. Yes, HN is a hotbed of intermittent
fasting propaganda [1], which may make it seem like there is general
agreement. But you'll find other communities pushing other diets as the one
true diet, so... more research is needed.

[1] Note, for example, that the submitter subtly but crucially changed the
title, which in the original says "works _for many_ " (emphasis mine).

~~~
downerending
I'm not particularly claiming that IF works. My main point is that _nothing_
we know of really works generally and reliably.

I've personally lost a significant amount of weight and kept it off
continually for more than a decade. But I don't really know how I did that,
nor do I have much confidence that whatever I did would work for others.

------
elric
For anyone interested in weight loss and heart health, please remember that
both are impaired by not getting enough sleep. Studies have shown that you're
way more likely to over eat if you get less than 7 hours of sleep a night.

Source: "Why we sleep" by Matthew Walker.

~~~
Jommi
This book? [https://guzey.com/books/why-we-
sleep/](https://guzey.com/books/why-we-sleep/)

~~~
slothtrop
His critique is flawed.

~~~
elric
Would you care to elaborate on that?

~~~
slothtrop
I made one short response to him here -
[https://news.ycombinator.com/item?id=21546850](https://news.ycombinator.com/item?id=21546850)
but will elaborate in the future.

------
kyle_morris_
I’ve been thinking a lot about how humans evolved and how differently we do
some things. Is there consensus on the eating patterns of prehistoric humans?

My understanding of how humans evolved to eat is pretty limited, but I would
guess unintentional intermittent fasting would have been commonplace in humans
over the past few hundred thousand years.

There seems to be consensus that eating a large variety of foods is great for
you, but is shifting your eating pattern, or even grazing, better than eating
at the same time, the same amount, every day?

Does your ancestral background impact how frequently you eat? Similar to how
some cultures are lactose intolerant due to historically not having access to
cows, could similar issues present based on how frequently we eat?

I’d love to find resources that have dug into those topics if anyone has
recommendations.

~~~
tinco
In general animals exposed to nature live shorter, not longer lives. It might
be worth investigating, but I've not seen anything to suggest we might become
healthier by restricting our diets to food available to effectively poor
people. Besides the obvious not eating food that we already know is unhealthy
and eating significantly more calories than we need.

------
chx
[https://www.eurekalert.org/pub_releases/2018-05/esoe-
cif0516...](https://www.eurekalert.org/pub_releases/2018-05/esoe-
cif051618.php) warns you intermittent fasting diets could increase diabetes
risk.

I wish I had data from before but after I attempted intermittent fasting I was
diagnosed with type 2 diabetes. It's possible I had it before, I alas haven't
had blood work done for a few years prior. I changed my diet, never attempted
fasting again and the 6.8 HbA1c dropped to and stayed steady at 5.3 almost
immediately.

~~~
danielheath
Fasting will make any deficiencies in your blood sugar regulation very, very
obvious.

------
xvilka
There is also antifragile[1] theory of fasting - body metabolism needs
randomness to prosper. So the idea is to not only do intermittent fasting, but
also do it randomly, randomly change your food habits, etc. Of course, even
with randomized food rations you need to keep them healthy.

[1]
[https://www.goodreads.com/book/show/13530973-antifragile](https://www.goodreads.com/book/show/13530973-antifragile)

------
humanlion87
I have been following IF on-and-off over the past few years. It has helped me
lose weight initially and then maintain it at a good spot. I have not done
detailed before and after blood work to know whether it has had other effects.
But one problem I have started having recently is acid reflux and acidity.
People immediately pounce on this and tell me that skipping breakfast is what
is causing increased acidity levels in my stomach. And my doctor is also
suggesting that I do not skip breakfast. The problem is I do not have any
concrete evidence for either case (skipping breakfast causes/does not cause
acidity). I am hoping to get my acidity issues under control first and then
maybe give IF another shot to see whether the acidity issues return. Just
wanted to throw out there that different people might have different
experiences with IF and it is very important to listen to your body.

~~~
bmd3991
Binge eating can cause acid reflux, so I wonder if it’s a similar mechanism.
Something about eating so much food in a small window maybe (?) doesn’t give
your body time and space to digest it properly

~~~
humanlion87
That's an interesting point, never thought about it that way. Need to read
more about it! If that is the case, then going back to IF might be a problem
for me :). Currently I am back on 3 meals a day (12:12) and have eliminated
certain types of foods that could cause acidity. And it's working for now.

~~~
doubleunplussed
Why not have breakfast but skip dinner?

Eating close to bedtime can cause reflux and FWIW I had less reflux when I
fasted after 4pm.

~~~
elric
I suspect the reason why it's common to skip breakfast in 16:8 and not dinner,
is because of social pressure. It's much more common to have dinner with
friends than breakfast. Skipping breakfast is way easiet for many people.

~~~
renw0rp
I did try IF before and I'm getting back to it now. Social aspect is the main
reason for skipping breakfast, not the dinner for me

~~~
lazylizard
Yes your friends rarely ask you out for breakfast...

------
SideburnsOfDoom
> Although it sounds counterintuitive, long periods without eating actually
> decrease your levels of the “eat now” hormone ghrelin.

I could not tell you if this is psychology or hormonal, but it seems to me
after having done it, that the benefit of intermittent fasting is not just
"fewer calories on average due to fast days" but also shifting the point at
which the body starts to sound the alarms about hunger. You "get used" to not
being sated, and it feels less like a problem that needs fixing, at least for
a few hours longer. This happens at some level well below conscious thought.

------
HiddenCanary
At university I used to intermittent fast as a side-effect of laziness to cook
breakfast.

Nowadays I've read the benefits of it and trying to replicate that but I just
get severe headaches when trying to do it. Anyone got any tips for avoid thing
that?

~~~
wahern
Two of the most common culprits to rule out would be 1) caffeine withdrawal
and 2) dehydration. People often don't drink as much, or not at all, when
they're not eating, and many don't even realize it.

When I work an all-nighter (36+ hours without sleep) I don't have much of an
appetite the next day and so tend not to eat anything. Because I'm not eating
I'm also not drinking much, which I like because I'm prone to slide into a
salt+soda spiral. But if I don't force myself to drink fluids I often end up
with a raging headache.

I'm not much of a breakfast eater and during periods when I drink a lot of
caffeinated soda I often get headaches from the caffeine withdrawal,
especially on the weekends as I tend to only drink soda when working.

~~~
dvdkhlng
And don't forget that maybe more than 20% of the normal water intake are due
to food, not just drinking [1], so if you eat less you need to compensate
water intake accordingly.

[1]
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5084017/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5084017/)

------
loceng
An accelerated version of intermittent fasting is longer term fasting - ideal
minimum being 3 days, although even only being able to handle 24 hours at
first is a great start; the next ideal number of days is 5 days, then 10 days,
then 20 days based on different changes that occur at those periods.

I always recommend people watch this by Dr. Jason Fung: 'Therapeutic Fasting -
Solving the Two-Compartment Problem' \- [https://www.youtube.com/watch?v=tIuj-
oMN-Fk](https://www.youtube.com/watch?v=tIuj-oMN-Fk)

~~~
arcturus17
I’m all for fasting but a 20-day fast without medical supervision sounds
crazy.

~~~
loceng
I never argued no medical supervision? Many people find it much easier to take
a daily electrolyte supplements while fasting, part of that is to increase
blood pressure in the body - so you'll avoid the added effects and added
pressure on the system of that.

If you're underweight then you shouldn't be fasting, that's the main concern
from my understanding.

Some people may just want to make sure their blood sugar levels are healthy,
perhaps along with checking for other abnormal factors. Obviously people who
may be fasting to lose weight may have other dis-ease progression due to the
weight or that caused their weight gain.

One other problem is many people don't understand how to come off of a fast
properly - and eating slowly isn't necessarily how. In reality what will
happen is if you don't know what foods you're normally eating that cause
irritation/inflammation in your GI tract and you return to those foods, you're
in for a very uncomfortable and painful experience because the contrast from
being away from those foods - from a low to no inflammation state to then
introducing them again, it's not fun and I say that from experience; it's part
of the process of how an elimination diet can work to help you understand what
foods you can tolerate or not, or you can do Igg food sensitivity testing and
save yourself a lot of trial and error time - though those tests don't account
for all sensitivities, so people need to not blindly trust that they are
encompassing all possibilities.

------
badrabbit
If you can break your carb addiction the rest is not that hard. It was very
similat to quitting cigarettes for me. Cut off carbs for a few days, it will
feel horrible until day 3, then you almost feel euphoric but you still have an
urge. Keep it up for a week then you start replacing the old habit with a new
one (intermittent fasting with keto diet for example, or cardio). Even when I
slack off, so long as I don't touch carbs I can just cut down on food intake
or workout a little bit and I will have so much more energy. If I actually
workout properly, people will notice changes in my energy level and attitude.
It's really insane why it is so hard to make simple changes with immense
benefits like this. I feel normal after stopping cigs and other vices but I am
telling you, cutting out or extremely reducing carb intake has had the most
impact on my life. If I didn't know better I'd be calling carbs an addictive
harmful drug (in reality, our modern way of life that requires minimal carbs
for fuel and healthy bodies that are energy efficient are causing a conflict
with traditional meals and ingredients). Once you get some control/discipline
over what you eat, controlling when you eat is a lot easier in my experience.
When it gets hard to stick to the diet, intermittent fasting can compensate
for lack of good calories.

------
bonestormii_
I am strongly prone to skipping breakfast and drinking black coffee all day
long, but I honestly do feel like it leaves me with less energy at the end of
the day, and makes me less likely to exercise.

If you are overweight, any weight loss may be good. If you aren't really
overweight, eating healthy regularly timed meals and working out are probably
a better bet for maintaining your physique.

------
arkj
>Intermittent fasting took off in the United States in part due to a 2014 TEDx
Talk (“Why fasting bolsters brain power”) by Mark Mattson

The link points to Michael Mosley's 2012 BBC documentary. Mark Mattson's TEDx
talk from 2014 is here
[https://www.youtube.com/watch?v=4UkZAwKoCP8](https://www.youtube.com/watch?v=4UkZAwKoCP8)

------
donniefitz2
For anyone interested in more info about IF, Dr. Jason Fung has a great book
about it.

[https://www.amazon.com/Obesity-Code-Unlocking-Secrets-
Weight...](https://www.amazon.com/Obesity-Code-Unlocking-Secrets-
Weight/dp/1771641258/ref=sr_1_5?dchild=1&keywords=Jason+Fung&qid=1592111190&s=books&sr=1-5)

------
slothtrop
Early intermittent fasting is the most powerful variation, on two fronts.
First, early dinner improve weight loss rate while conversely very late dinner
worsen it, along with glucose tolerance. Second, consuming high protein
breakfast has strong associations with weight loss and better lipid profile.
You can get the best of both worlds.

There's lots of research to this effect -
[https://www.nature.com/articles/ijo2012229](https://www.nature.com/articles/ijo2012229),
[https://journals.plos.org/plosbiology/article?id=10.1371/jou...](https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.3000622),
[https://academic.oup.com/jn/article/127/1/75/4728738](https://academic.oup.com/jn/article/127/1/75/4728738)
,
[https://onlinelibrary.wiley.com/doi/full/10.1002/oby.20460](https://onlinelibrary.wiley.com/doi/full/10.1002/oby.20460),
[https://academic.oup.com/ajcn/article/104/4/1160/4557123](https://academic.oup.com/ajcn/article/104/4/1160/4557123),
[https://academic.oup.com/ajcn/article/104/4/982/4557122](https://academic.oup.com/ajcn/article/104/4/982/4557122),
[https://www.mdpi.com/2072-6643/11/11/2624/htm?sfns=mo](https://www.mdpi.com/2072-6643/11/11/2624/htm?sfns=mo),
[https://www.nature.com/articles/ejcn2016182](https://www.nature.com/articles/ejcn2016182),
[https://www.sciencedirect.com/science/article/pii/S027153171...](https://www.sciencedirect.com/science/article/pii/S027153171400195X)

------
2T1Qka0rEiPr
I lost a little over 50lbs a number of years ago, following a 5:2 diet. Quite
frankly, I found it pretty horrible. Selecting 2 days in which you won't eat
(much) is pretty tough, and the obvious candidates would be your working days,
but you should expect to be grumpy AF during them in all honesty.

These days, I generally stick to a 16:8 approach of IF (I typically eat
between 13:00-21:00). I find that it works pretty well for me. I should note
that I'm very active (exercise every day, running, cycling, or lifting
weights), and that I _still_ typically eat 3 meals, albeit within a smaller
window. I think being sceptical of food science is smart, so all I can say is
that it works for me.

------
BrandoElFollito
One day I decided to skip breakfast (I am not really hungry in the morning). I
would eat at 20:00 and then at 12:00 the next day. 16 hours of fasting for a
year or so (I still continue, recently gave up because of COVID but will be
back when normality is back too).

I was not hungry, I did not loose weight, I did not feel better or worse.

I wonder whether some people are just optimized for this eating style, without
specific impacts on their health or body.

------
Izkata
> How do you start? Agatston told me to start by skipping one meal a day,
> usually breakfast.

This sounds especially odd to me, as skipping breakfast has long been one of
those well-known ways to accidentally gain weight... (explanation typically
being that you end up hungrier at lunch/dinner and eat more over the whole
day)

~~~
Broken_Hippo
Are we sure about this? I mean, wasn't "breakfast is the most important meal
of the day" an advertising slogan to sell more?

Additionally: I think this probably has more to do with the person. My mother
is outright miserable without breakfast, which makes sense. She is hungriest
early in the day. She doesn't have much issue completely skipping dinner or
eating very little the rest of the day. I'm the opposite. Eating too early
means I simply eat more food that day - and I'm not even hungry the first hour
or two that I'm awake. I don't see a point in eating when I'm not hungry, so I
generally don't. It is much easier to simply skip food early in the day, snack
on something small for lunch (cheese and bread, fruit, etc), and have a nice
dinner.

------
Wolfenstein98k
It works for "systems" thinkers rather than "goals" thinkers. Easier to apply
a system than try to reform every habit of eating constantly.

I suspect engineers and the like are disproportionately the former.

(See Scott Adams for a description of the systems/goals dichotomy).

------
netman21
I like the explanation that IF gives your body a chance to go into ketosis.
And, by extension, a keto diet provides the same benefits as IF. Combining the
two is easy since in my experience you rarely get hanger pangs when you don't
eat carbs.

------
simonebrunozzi
Well, at least the title is exactly informative, instead of making me guess
what the conclusion of the article is about.

I tried IF for a while. Had mixed results (mostly positive, just not as
positive as expected). Willing to try again.

------
sudhirkhanger
One thing that IF guys try to not talk about is that the only way to lose
weight is by eating less. If you eat same amount of calories with IF then you
won't see the same weight loss benifits.

------
bobcostas55
It "works" exactly like calorie restriction, there's no magic to IF.

From a literature review[0]:

>Twelve studies used calorie-restricted diets as a comparator to IF and found
equivalent weight loss in both groups.11,15-17,19,22,27,28,33,41-43 Study
duration was 8 weeks to 1 year, with a combined total of 1206 participants
(527 undergoing IF, 572 using calorie restriction, and 107 control
participants) and demonstrated weight loss of 4.6% to
13.0%.11,15-17,19,22,27,28,33,41-43

[0]
[https://www.cfp.ca/content/cfp/66/2/117.full.pdf](https://www.cfp.ca/content/cfp/66/2/117.full.pdf)

~~~
xpe
IF offered better glycemic control for Type II Diabetes (see the last
sentence):

> Synthesis All 27 IF trials found weight loss of 0.8% to 13.0% of baseline
> weight with no serious adverse events. Twelve studies comparing IF to
> calorie restriction found equivalent results. The 5 studies that included
> patients with type 2 diabetes documented improved glycemic control.

~~~
pbhjpbhj
Is "glycaemic control" a general benefit, or is that only good for people with
diabetes (and other conditions?)?

I've wondered if IF makes a difference in that way. If there's a _pain au
chocolat_ for me, and I eat it at breakfast is that different to me eating all
the same food in the day but eating that _pain au choc_ after lunch?

~~~
xpe
> Is "glycaemic control" a general benefit, or is that only good for people
> with diabetes (and other conditions?)?

Great question. My guess would that it would be correlated, at least. If you
check this out, please share back what you find.

------
Kiro
I don't understand the 16:8 idea. I would still eat 3 meals, just with dinner
a little earlier. 8 hours window feels too big to be called fasting.

~~~
globular-toast
Even a "normal" 3 meal pattern involves fasting overnight. That's why we call
the first meal breakfast. This is just extending that overnight fast to 16
hours.

I think if you tried to eat 3 meals in 8 hours you'd eat smaller meals.
Otherwise you'd be stuffing yourself full.

~~~
Broken_Hippo
Not necessarily. IIRC, food leaves your stomach within 2-5 hours, and it
varies depending on person and what the food is. I'm gonna guess you could fit
in a light breakfast and a fairly decently sized lunch and dinner in that
8-hour window.

------
darepublic
The actual title includes the phrase "works for many"

------
a-saleh
Damn you paywall, I did wanted to read this! :D

I am not certain how generalizable this is. Because this sorts of diet
research relies most often on self-reporting, I mostly read it by prepending
'People exist for which ...'. And that is good to know, and hopefully they are
not outliers by too much, but it probably won't be silver bullet for
everybody.

I.e. I remember hearing two twich streamers talk about their diets an one said
how she really enjoys intermittent fasting, while other mentionsh how he needs
to eat something at least every four hours, or he literally sees his apm in
Starcraft drop :D

------
brainzap
I would prefer we would just call it "eat less"

~~~
meesterdude
that's entirely wrong though. Because it's not about cutting the calories of
your meals in half - it's about having longer gaps between your caloric intake
times, so your body goes into ketosis.

~~~
pbhjpbhj
Is that what all IF it's about?

