What’s all the buzz?
When it comes to maintaining health or managing chronic disease- fasting seems to come up as the answer to everything.
There is a lot of evidence supporting fasting as a tool in the treatment of autoimmune conditions (i.e. lupus, Hashimoto’s thyroiditis, psoriasis, rheumatoid arthritis, etc.) and metabolic diseases (i.e. obesity, heart disease, type II diabetes, etc.). Fasting, done properly, can promote a process called “autophagy”- the body’s systematic breakdown and recycling of unhealthy or dysfunctional cells. This process is how the body tries to get rid of cells that aren’t working properly and “resets” to improve self-regulation. This process is important in the management of autoimmune diseases and chronic inflammation.
It has also been shown to alter the gut microbiota (i.e. the bacteria found in your digestive tract), increasing diversity and amount of beneficial bacteria and reduced the pro-inflammatory immune cells while increasing the regulatory immune cells. This helps in the reduction of inflammation, not only in the digestive tract, but in other areas of the body.
Fasting may be beneficial for most people, but it will be more beneficial for those who have done the preliminary groundwork. This involves making the diet and lifestyle changes that are in line with your health goals and often means working with a qualified clinician to ensure that the fasting is done both safely and effectively. Working with a qualified clinician should be considered if you are unfamiliar with fasting, have recently started managing significant health issues, or have blood sugar regulation issues (i.e. diabetes).
Historically, our ancestors would have existed in times of alternating “feast or famine”. Sometimes they found food, and sometimes they didn’t. It is strongly believed that our current lifestyle of always indulging in “feast” conditions may be contributing to our decline in health- not to mention the decline in the nutritional quality of the food we eat. Not only are we eating more, we are eating more unhealthily.
Types of fasting:
Fasting is the abstinence from food or the limitation of food. We will often routinely do this by not eating between dinner and our first morning meal or “breakfast” (which literally means to “break the fast”). This time span is usually 8-12 hours. It is also often done for religious or spiritual reasons.
Therapeutic fasting is abstaining from food for a specific amount of time, with the objective of using fat reserves for energy and stimulating autophagy.
Intermittent fasting involves cycles of eating and fasting throughout the day, or during the week. This can involve abstaining from food completely OR doing a “partial fast” (i.e. limiting caloric intake to 500-800 calories) during fasting periods.
Some examples of intermittent fasting routines are as follows:
- Time-restricted eating: eating is restricted to a specific time to day, usually within 6-12 hours
- 16/8: 16 hours of fasting, 8 hour window during which you would consume food (not “8 hours of eating)
- 5:2: Food is consumed unrestricted 5 days a week, with fasting or partial fasting during remaining 2 non-consecutive days of the week
- 24 hour or 36 hour fast: fasting for a full 24 or 36 hours; 24 hour fast may be done 1-2 times per week (i.e. like in the 5:2 fast), the 36 hour extended fast may be done less frequently (i.e. once per week or month) and may be more effective in starting ketosis.
Fasting with Autoimmune Disease & Environmental Exposures:
In cases of autoimmune disease and chronic inflammation, therapeutic fasting would be most beneficial if done several times (usually for several days at a time), over a period of several months. Many patients would benefit from some initial preparation to ensure that the body is “keto-adapted” (i.e. primed to target fat cells for energy in the absence of glucose) while in a fasting state and is not breaking down muscle tissue for energy.
When managing autoimmune conditions or environmental exposure, it is important to be working with a qualified and knowledgeable clinician in order to achieve the best results. Your clinician should be implementing an initial detoxification and drainage program, along with a therapeutic diet prior to attempting an extensive fasting protocol. In cases of environmental exposure, many of the toxicants are fat-soluble and will be released during autophagy and ketosis, and may result in moderate-to-severe aggravation of existing health conditions. Working with an Environmental Medicine- trained clinician will help to reduce the aggravation that you may experience during treatment and will improve your clinical outcome.
Cautions, Contraindications & other notes:
Fasting may be beneficial for most people, but it will be more beneficial for those who have done the preliminary groundwork. This involves making the diet and lifestyle changes that are in line with your health goals and often means working with a qualified clinician to ensure that the fasting is done both safely and effectively. Working with a qualified clinician should be considered if you are unfamiliar with fasting, have recently started managing significant health issues, or have blood sugar regulation issues (i.e. diabetes).
Contraindications to fasting include pregnancy, chest/breastfeeding, actively trying to conceive, amenorrhea (loss of menstrual cycle), and those with eating disorders (i.e. anorexia or bulimia). Children and young adults going through puberty should not be fasting unless medically indicated.
Those with diabetes and who may be on medication for regulating blood sugar and blood pressure should be monitored by a clinician, as fasting can lower blood sugar levels and blood pressure, which may require changes to medication dosing.
Fasting should not be done indefinitely, or without cycling in “feast” periods, as prolonged caloric restriction may result in hormonal changes (i.e. loss of menstrual cycle, hypothyroid function, etc.) and may cause the body to go into “starvation mode”, affecting stress (i.e. cortisol and epinephrine) levels. Women are more susceptible to these changes due to the nature and cycle of female hormones.
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Photo credit: julie aagaard