Eat Stop Eat 1 Copyright © 2007 and Beyond by Strength Works, Inc. All rights Reserved No portion of this book may be used, reproduced, or transmitted in any form or by any means, electronic or mechanical, including fax, photocopy, recording, or any information storage and retrieval system by anyone but the purchaser for their own personal use. This manual may not be reproduced in any form without the express written permission of Brad Pilon, except in the case of a reviewer who wishes to quote brief passages for the sake of a review written for inclusion in a magazine, newspaper, or journal, and all of these situations require the written approval of Brad Pilon prior to publication. The information in this book is for educational purposes only. The information in this book is based on my own personal experiences and my own interpretation of available research. It is not medical advice and I am not a medical doctor. The information within this book is meant for healthy adult individuals. You should consult with your physician to make sure it is appropriate for your individual circumstances. Keep in mind that nutritional needs vary from person to person, depending on age, sex, health status and total diet. If you have any health issues or concerns please consult with your physician. Always consult your physician before beginning or making any changes in your diet or exercise program, for diagnosis and treatment of illness and injuries, and for advice regarding medications. Eat Stop Eat 2 For Reference: Pilon, Brad. Eat Stop Eat, 5th Ed. Ontario, Canada: Strength Works, 2012. E-book. Eat Stop Eat 3 Contents A Special Note 5 Preface 9 How it All Started 12 Introduction 15 The Fasted State 21 The Disappearance of the Fasted State 24 Forget Everything You Have Ever Read About Fasting 28 Fasting and Your Metabolism 32 Fasting and Exercise 38 Fasting and your Brain 44 Fasting and Your Muscle Mass 46 Fasting and Hunger 53 Fasting and Blood Sugar Levels 59 Other Misconceptions of Fasting 63 The Health Benefits of Fasting 74 Decreased Insulin Levels & Increased Insulin Sensitivity 79 Decreased Blood Glucose Levels 82 Increased Lipolysis and Fat Burning 83 Eat Stop Eat 4 Increased Glucagon Levels 87 Increased Epinephrine and Norepinephrine levels 89 Increased Growth Hormone Levels 90 Increased Weight Loss and Increased Fat Loss 96 Decreased Chronic Inflammation 98 Increased Cellular Cleaning 102 Health Benefits – The Conclusion 106 The Eat Stop Eat Way of Life 108 How to fast Eat Stop Eat style 111 How to Eat Eat Stop Eat style 115 What to do While Fasting 125 How to work out with Eat Stop Eat 128 Designing your own workout program 134 Sticking with it 135 A note on cardio for weight loss 136 Other Health Benefits of Exercise 141 How to keep it off 142 Eat Stop Eat Conclusions 145 Eat Stop Eat Frequently Asked Questions 149 References 162 Eat Stop Eat 5 A Special Note on This Edition First of all, let me be clear that I was well aware of the immense gap between peoples’ attitude toward health and fitness and the theories found within this book back when it when was first published in 2007. I knew that people had generally accepted that strict dietary restraint and an almost relentless workout program were essential for weight loss. Not only this, but it was believed that a serious lifestyle modification had to occur that made you almost obsessed with health and nutrition. I was all too aware that for some curious reason we had accepted the idea that losing weight had to be extremely difficult and the concept that long-term weight loss success meant a life of dedication and extreme discipline. Back in 2007, even the slightest suggestion that we could actually cause a genuine reduction of body fat WITHOUT extremely regimented and inflexible dietary restrictions was often met not only with disbelief, but also hostility. Few were prepared to hear or accept a simpler solution. Eat Stop Eat 6 The diet industry is huge, and worth billions of dollars in annual profits. This not only includes the obvious examples of over the counter diet pills, but also weight loss centers, weight loss coaches, weight loss books, and even on-line weight loss societies. Combine this with the shocking boom of twenty-something year old Internet marketers making millions selling ‘diet advice’ on-line and it becomes obvious that the weight loss industry was ripe for a big, strong dose of common-sense thinking. I knew that Eat Stop Eat was going to cause a shockwave in the diet industry, and that I was going to have to spend a great deal of my time defending the concepts within it. But like I said, this was almost a given. It is the NORM for radical new concepts that receive a lot of attention to arouse a sharp division of opinion among expert ‘commentators’. Yet the fight for Eat Stop Eat’s acceptance was not nearly as uphill as I had imagined. Sure, it had its detractors and nay-sayers, but for the most part even the harshest scientific critic quickly came to realize the simplicity and effectiveness of Eat Stop Eat and appreciated that it was supported by very sound and logical scientific evidence. It seems that in a matter of just 3 short years, Eat Stop Eat has gone from being a controversial ‘fringe’ dietary ‘fad’ to becoming an accepted dietary approach to losing weight that is being supported by doctors, dietitians, and other mainstream health experts. Eat Stop Eat 7 Biologist J.B.S. Haldane said it best when he pointed out that there are four stages of scientific acceptance: 1) This is worthless nonsense 2) This is an interesting but perverse point of view 3) This is true but quite unimportant 4) I always said so Eat Stop Eat has hit the “I always said so” phase of acceptance. This is very exciting to me, and many others involved in the diet and weight loss industry. People have begun to accept that losing weight can be accomplished using a multitude of different diets, as long as the diet created some sort of decrease in caloric intake. Not only this, but the concept that the best diet is the one you enjoy and can stay on the longest, has really caught on. Despite these facts, there is still a growing amount of nutrition misinformation that is available in the mainstream weight loss industry. And, quite ironically, obesity rates are still increasing. In fact, the average percent body fat in North America has become startlingly high. (The average body fat for men is 25% and for women is closer to 40%) Eat Stop Eat 8 Common sense and sensibility merges with the weight loss industry. The simple truth is that research illustrates an increased supply of food is more than sufficient to explain this obesity epidemic.1 I am almost positive that no one is happy with the North American average of 25% and 40% body fat for men and women, respectively.2 As such, there is still a need to expand on the successful theories of Eat Stop Eat to help as many people as possible realize that weight loss does not have to be complicated. Let’s start with what we already know about weight loss: • Carrying extra body fat is really bad for us, both physically and emotionally. • Weight loss is not a mystery and the fundamental principles have never changed. It’s our ability to apply these principles that dictates how successful we are at losing weight. • Since you are reading this book, you have a personal interest in weight loss. A Caveat: Prevention is better than a cure. While the principles of Eat Stop Eat are often only thought of as a way to lose weight, it is important to remember that Eat Stop Eat is also an effective way to maintain weight loss, AND to prevent weight gain from happening in the first place. Simply put, when adapted to fit your own personal lifestyle, the principles of Eat Stop Eat can apply to everyone. Eat Stop Eat 9 Preface Take a second before reading this book and think about all the diets you have heard about and read about in recent years. Each diet had its own little hook that made it stand out, and each diet had thousands of loyal followers that swore that their diet was the only one that worked. Now consider the real-world evidence that is right before your eyes. Every day you see hundreds of people, all with different body shapes and all following different diets. I will use professional bodybuilding as an example. Imagine two groups of bodybuilders ready to step on stage at the highest level of competition; their veins popping out everywhere, with tanned, oiled skin, and almost nonexistent body fat. The first group consists of bodybuilders from the 1950’s and 1960’s. These bodybuilders were able to get into phenomenal shape using diets that were low in fat, high in carbohydrates with moderate amounts of protein. The second group consists of bodybuilders from the 1990’s and beyond. They got into phenomenal shape using very different diets that consist of moderate amounts of fat, low carbohydrates, and very high amounts of protein. Eat Stop Eat 10 Both groups of bodybuilders were unbelievably lean. Both groups used various supplements and drugs. However, both groups followed very different nutrition plans. Yet, somehow they all managed to get their body fat down to unbelievably low levels. Throughout the last five decades, the diets of bodybuilders have changed dramatically. Depending on the bodybuilder and the era, they may have eaten six meals a day, or they may have eaten more than a dozen. Some bodybuilders ate red meat while others did not. Some did hours of cardio, some did no cardio at all, yet they were all able to lose fat and get into ‘contest shape’. The reason all these bodybuilders could get in shape on so many different styles of diets is simple: for short periods of time, every diet will work if it recommends some form of caloric restriction. And if you follow a calorie-restricted diet you will lose weight, guaranteed. The problem is, you simply cannot follow a super-restrictive diet for a long period of time. Sure, a truly dedicated individual may be able to follow a very restrictive diet for 12 weeks and get into phenomenal shape. With the right amount of dedication, a person can even look like they just stepped off the cover of a fitness magazine. And a very small and unique group can do this for years on end. For the rest of us, this way of eating is too restrictive, too intrusive on our lives, and far too limiting to be done effectively for any real length of time. Now, what if I told you that these types of long restrictive diets are simply not necessary for weight loss? What if I told you that there is a way to eat and a way to live that can give you amazing health benefits, help you lose weight, and does not involve any prolonged periods of food restrictions, eating schedules, supplements, or meal plans? Eat Stop Eat 11 In the following pages I am going to share with you a discovery that I made as a result of years of research and schooling, a career in the sports supplement industry, and an obsession with nutrition. I am going to present you with the reasons why I think most diet plans are unnecessary, too restrictive, and ultimately too complicated to work long term. And most importantly, I am going to describe what I believe to be the single best way to eat and live that will help you lose weight and keep it off, without any of the complex plans, rules, and equations that is typical of most diets. After all, I don’t consider this method of eating a diet. It’s a way of eating that restricts calories, but that can also ultimately grow into a way of life. I must warn you in advance, many of these ideas are ‘different’ in that they do not agree with the current nutrition trends. I promised myself when starting this project that I would not merely accept the current rules of nutrition just because they happened to be the rules that are currently en vogue. As the bodybuilders in the example prove, many different styles of nutrition can result in the development of astonishing physiques. There probably is no “right” way to eat. The best we can hope for is finding the way that works the best for you. Nutrition, just like all science and medicine, is always evolving and changing. So even though the ideas in this book may be radical now, I believe that someday they just might be the new rules of nutrition! I am positive that if you read this book with an open mind, you will find that everything I have written makes sense. It may be different than what everyone else is telling you, but it is proven and backed up by a large quantity of scientific research, and it can change your life. Eat Stop Eat 12 How it All Started I walked away from my career in the sports supplement industry in May of 2006. It wasn’t a bad split, and I did not want to give up on the industry altogether, I just wanted to start fresh. To fully explain this decision, I have to take you back about twenty years. I have always been obsessed with exercise, health, and nutrition. At 10 years old, I could already boast a very impressive collection of Muscle & Fitness Magazine, and a couple of years later I was also collecting issues of Men’s Health. I can remember reading about bodybuilders like Lee Haney, Arnold Schwarzenegger and Lou Ferrigno and all of the articles concerning their diet and exercise programs. It was these articles that piqued my interest in the science behind fat loss. At 16 years old, I had a subscription to the American Journal of Clinical Nutrition. I would read any research paper that involved nutrition and fat loss. It would take me about a day to read each article because I had to stop and check almost every word in a medical dictionary. At 17 years of age, I started working at a local supplement store. This was my first official step into the health and nutrition industry and I have never looked back. Eat Stop Eat 13 When I started studying nutrition at university, I had only two goals – to learn everything I possibly could about nutrition and metabolism, and to graduate with honors. In the spring of 2000, I accomplished both of them. Almost immediately after graduating from university, I was fortunate enough to be hired as a research analyst at one of the world’s leading supplement companies. Fast-forward to June of 2006. I had just spent the last six years of my life working in one of the most secretive industries in the world. During this time, I had been entrusted with protecting some of the most confidential information in the entire industry. I was the person responsible for the inner dealings of our Research & Development Department. Unfortunately, this was part of the problem. Part of my job was to review bodybuilding and fitness magazines. Every month I would have to read through the top ten magazines on the market. I was constantly reading about the ‘latest and greatest’ diet methods. After years of reading magazine after magazine, I didn’t know what to believe anymore. Each month, it seemed like the newest diet methods contradicted the diet methods that were in last month’s magazines. I started to think that the weight loss industry was full of nothing but confusing and constantly recycled misinformation. When it came to the science of losing weight, every so-called ‘nutrition guru’ and weight-loss personality had his or her own theories on what did and didn’t work. After years of reading and evaluating all of these nutrition and diet programs, I was actually starting to ignore my previous doubts and get consumed by the hype! Despite all of my formal education in the nutrition field, even the most absurd diet theories eventually started to sound logical to me, even though I had never come across any research that could convince me that these theories were supported by strong scientific evidence. Eat Stop Eat 14 In reality, the vast majority of what I had read in these magazines was just theories and speculation. Some of them were based on science while others were complete gibberish. Many were contradictory to one another, and others even defied the fundamental laws of thermodynamics and science. Month after month, dozens of magazines would appear on my desk, and month after month, I would see new and old diet ideas being trumpeted as the newest, most effective way to ‘blowtorch through stubborn body fat’. At this point, I noticed a funny thing about the industry - if an idea is published enough times, and if enough people accept it, it becomes true, no matter how inaccurate it really was. Whoever said, “you can say the same lie a thousand times but it doesn’t get any more true,” has obviously never been involved in the nutrition industry! The bottom line is that I got into the sports supplement industry for the same reason I eventually left. I wanted to understand the true rules of weight loss, and I wanted to figure out how we should really eat for health, energy, peak performance, and for weight loss. I ended up leaving my career in the industry so that I could write this book. Eat Stop Eat 15 Introduction As part of the background research for this book, I made it my goal to uncover the true scientific facts behind weight loss and nutrition. I’m not talking about the scientific ‘facts’ that are thrown around every day by food companies and marketing gurus. You know, the ‘eat this, not that’ facts or the ‘recent research has shown’ ‘facts’. I wanted to find the cold, hard truths. I was looking for the nutritional equivalent of death and taxes. My first step in this quest was to read every nutrition and diet book I could get my hands on. I read and re-read the following books: The Atkins revolution, Protein power, Body for Life, The Zone, The South Beach Diet, French Women Don’t Get Fat, The Warrior Diet, The Metabolic Diet, Volumetrics, The Obesity Myth, Health Food Junkies, An Apple a Day, What to Eat, the Omnivore’s Dilemma, Real Foods, The End of Overeating, Eat Right 4 Your Type, Good Calories Bad Calories, Food Politics, as well as various ‘underground’ books on diet and nutrition like Dan Duchaine’s Body Opus. I didn’t just read these books. I analyzed them. I compared marketing tactics, writing styles, and persuasion techniques. If the book quoted scientific references, I sought Eat Stop Eat 16 out the reference and reviewed it in its entirety. My goal was to dissect our current nutrition beliefs and to find track their evolutions and origins. On top of this, I also read and critically analyzed hundreds (not an exaggeration) of research papers, and re-read several of my nutrition textbooks. I even went so far as to enroll in graduate school to study Human Biology and Nutritional Sciences, and let me tell you, it took an almost unhealthy desire to uncover the truth to drive me to re-enroll in school after a seven-year hiatus, with a pregnant wife and a busy consulting job! It was a long commute back and forth from school every day, but having the opportunity to study nutrition at the graduate level was worth the sacrifice. So what did all of my research uncover? Firstly, I can say that most (but not all) people who talk about scientific research on-line or in magazines are not credible sources of scientific information, nor can they properly analyze the meaning of any scientific research. What they do is called “data mining”, where they scan research papers looking for interesting sound bites or quotes. Basically, they try to summarize 2 to 3 years worth of scientific investigation in one short and snappy quote. It’s great reading, but it rarely gets to the truth of the topic. This is not meant as a self-serving ego-boosting statement, but rather as a testament to the importance of obtaining a proper education. I also realized that even having an advanced education in one specific topic does not make you an expert in all things health related. Having a PhD in muscle physiology does not make you an expert in fat loss, and vice versa. Nor does being a Medical Doctor necessarily give you the scientific background you need in order to truly understand the complexities of nutrition, and more importantly to be able to see Eat Stop Eat 17 through the deceptiveness of nutrition marketing (many U.S. medical schools fail to meet the minimum 25 required hours of nutrition education set by the National Academy of Sciences).3 Eat Stop Eat 18 Finally, I can tell you that based on my research studying nutrition, fasting, and weight loss in graduate school, I have realized that there are only two absolute truths when it comes to nutrition and weight loss. 1) Prolonged caloric restriction is the only proven nutritional method of weight loss and 2) Human beings can only be in one of the following states: Fed or fasted. That’s it. In my opinion, these are the only two facts that are undeniable. Everything else is open for debate, which is the problem with nutrition today – it is made out to be so complicated and confusing that nobody knows what to believe. Most scientific research findings seem to do nothing more than add to the already confused and muddled nutritional theories and diet recommendations that exist, and the cause is clear as day – research on nutrition and food is no longer conducted to improve our health and well being. It is conducted for marketing purposes and as a method to get us to buy one product over another, and it is all based on us being constant consumers. In fact, it was in an amazing article in Scientific American magazine written by renowned food expert Dr. Marion Nestle where I became aware that it was in the early 1980’s food companies had no choice but to attempt to change the way we eat. Faced Eat Stop Eat 19 by stockholder demands for higher short-term returns on investments, food companies were forced to expand sales in a marketplace that already contained an excessive amount of calories. Their only option was to seek new sales and marketing opportunities by encouraging formerly shunned eating practices such as frequent between-meal snacking, eating in bookstores, and promoting the money-saving value of larger serving sizes.4 To be clear, our entire style of eating in North America has been molded to support the interests of major food companies. You may be wondering ‘How can a select few people change the way entire countries decide to eat?’ Well, in order to promote this new style of eating, enormous amounts of money had to be spent on research supporting the health benefits of this style of eating. As far as I can tell, most research being conducted on food and nutrition these days is done simply for the purpose of food marketing. This is because the money that funds nutrition research is typically donated by a food company or supplement company. This so-called ‘donation’ or grant comes with the hope and expectation that the research will produce a health claim or other marketing claim that the company can then advertise as a selling feature for their product. As it turns out, health claims on foods and supplements can be incredibly lucrative, and the politics behind nutrition are undeniable. It was in a book titled “What to Eat” by author and researcher Marion Nestle (the same author who wrote the article in Scientific American), where I read the following quote – “The real reason for health claims is well established: health claims sell food products.”5 I couldn’t agree more. Eat Stop Eat 20 The bottom line is that research creates health claims, and health claims sell products. Whether the product is some new ‘functional’ food or the latest diet program, if research says it works, it will sell more, guaranteed. Very soon into my readings I began to realize that the research on weight loss had become so skewed with politics that it has turned into the world’s most ironic oxymoron. After all, the research was trying to uncover the completely backwards idea; ‘what should we eat to lose weight?!’ When I realized that almost all nutrition research was working under this completely backwards paradigm, I understood that I had only one choice. If I was to avoid all of the bias and vested influence in today’s nutrition research then I had to go back to the absolute beginning. I had to conduct a thorough review of exactly what happens to human beings in the complete absence of food. Eat Stop Eat 21 The Fasted State The definition of fasting is quite simple. I’ve read through countless dictionary entries and website descriptions of fasting, and have decided that the best definition of fasting is the following: “The act of willingly abstaining from some or all food, and in some cases drink, for a pre-determined period of time.” The key word in this definition is “willingly” as it is the difference between fasting and starving. Other than this one small difference, the net result is the same – the purposeful abstinence from caloric intake over a given period of time. Now, a lot of people confuse 'starvation' with wasting - wasting is the end result of prolonged caloric restriction - where your fat reserves are almost completely used up and can no longer supply your body with enough energy to meet its needs. This is when you see abnormal physiology such as muscle wasting (loss) and a slowed metabolism. So 'wasting' is the end result of prolonged extreme calorie restriction – occurring after months or even years of a chronically low intake and possible nutrient deficiencies, but not something that happens in a 72-hour period without food. So you are either fed or fasted, however ‘fasted’ can mean 12 hours or 12 weeks, so for the purpose of my research I decided to focus on short-term fasting, studying the metabolic effects of fasting between 12 and 72 hours. While researching, I observed some benefits to studying short-term fasting as a way to find the truth behind Eat Stop Eat 22 nutrition and fat loss. The most important is that people with vested interests in selling consumable products have no interest in studying fasting. Fasting automatically rules out the use of any sort of food, health supplement, or newly touted “functional foods”. Much to the dismay of food companies, you can’t put fasting into a pill and sell it, and as we have already discussed, the purpose of most nutrition research these days is the development of new products. By default, because you do not consume anything while you are fasting, research on fasting contains very little bias from large food company funding. After all, why would a food company spend money proving there is a benefit to eating less of their products? Another benefit of studying fasting is that there is an extremely large volume of research that has been conducted on fasting, and more research comes out almost every day. Throughout history, various cultures have used fasting in many different types of rituals and celebrations, and still use fasting within those traditions to this day. Almost all major religions have a degree of fasting built into them. From political protests to healing rituals, and even for good-old weight loss, there are many historical accounts of various people fasting for different reasons. With the exception of fasting for religious purposes, the practice of fasting has all but disappeared in North America. Our ancestors also fasted simply due to the poor availability of food. While modernday humans in many developed countries are used to being able to eat a solid three meals per day, animals in the wild eat only when food is available, and most likely this is also how our hunter-gatherer ancestors ate. Eat Stop Eat 23 And let’s not forget that the majority of the world’s population still lives without adequate food supply. The fact that we’re faced with a problem of too much food makes us the lucky ones. Of course, this creates an odd sort of irony in the fact that you are now reading a book about how to deal with the consequences of the extra food. Eat Stop Eat 24 The Disappearance of the Fasted State As I stated in the beginning of this book, from a nutritional point of view, a human being can only be fed or fasted. By saying this, I mean that we are either in the process of eating and storing the calories that come from our food, or burning these same calories as we burn stored energy. This energy is stored in the form of fat and glycogen (the storage form of sugars and carbohydrates in our bodies). Our bodies are designed to eat food when food is available and use the calories we have stored as fat when food is scarce. These are our only two options. Consider them the Yin and Yang of nutrition and health. FED - Eating and storing Calories FASTED - Not eating and burning Calories. Eat Stop Eat 25 Fasting is the simplest method our body has for maintaining its caloric balance. Store a little when we eat, burn a little when we don’t eat. Recent research suggests the problem is that we spend as much as 20 hours a day in the fed state.6 We are constantly eating and storing food and we never really give ourselves a chance to burn it off. So the yin and yang of fed and fasted has been replaced by a constant fed state, where we helplessly try to figure out how to continue eating and somehow lose weight at the same time. This is a very scary scenario when you consider the fact that our bodies are designed to store fat whenever it is provided with an amount of calories beyond its needs. In order to restore the balance of fed and fasted states, we have no choice but to go through periods of under-eating to match our large periods of over-eating. As a very crude example, imagine a hunter who has caught and eaten an animal, and foraged around and found some berries. Once the meat is gone and the berries have all been picked, the hunter has no choice but to move on in search of more food. Based on this ancestry, it seems logical to say that this is precisely how our bodies were designed to function. So if our bodies were designed to feed and then fast, why doesn’t anyone fast anymore? Most likely it is because the concept of fasting for weight loss and health has been villainized in western society as it goes directly against one of the most basic principles of business – supply and demand. To the food industry and various government agencies, the idea of people eating less is bad for business. Eat Stop Eat 26 Consider that each day in the United States, the food industry produces enough food to supply every single person with almost 4000 calories.7 On top of that, 10 billion U.S. dollars per year goes into the advertising and promotion of this food.8 It would be a huge financial disaster for many food companies if all at once everyone in the United States decided not to eat for one day out of the week. This is why the food and nutrition industry is willing to suggest many different theories on how to lose weight, as long as it means we continue buying and consuming foods. And not only that, they’re trying to sell the idea of buying MORE foods and consuming it MORE often. Think of all the diet suggestions you know. They all rely on the continued intake of food. Eat six small meals a day. Eat high protein. Eat breakfast (the TV commercials say it’s the most important meal of the day). Eat cereal. Overeat, cycle your carbohydrates, cycle your proteins, Eat lots of high calcium foods. Eat whole wheat. Take diet pills. Whatever the recommendation, it always revolves around making sure that the population is continuously consuming food and food supplements. After all, this is how companies refer to us - we are consumers (not people). And if you look up the word ‘consumer’ in the thesaurus you will find that its synonym is ‘customer’. How many times have you heard a company representative say things like, “We value our customer”? Well, of course they do! We buy (and consume) their products! Without us, there would be no profits and no company. In a day and age where so many people are trying-and failing- to lose weight, it seems improbable that the answer is simply dieting. In fact, in his very controversial book “The Obesity Myth,” author Paul Campos states he does not believe that dieting is an effective method of weight loss. Indeed, Mr. Campos goes so far as to say the idea that “People could lose weight if they really wanted to” is, in fact, a lie.9 Eat Stop Eat 27 Although I’m not willing to go quite as far as Mr. Campos, I am willing to say that every single one of today’s popular diets is doomed to fail in the long term. In my opinion, no matter how strong your willpower, it will eventually be overridden by the power of marketing, advertising and the lure of great tasting food. After all, no one really wants to diet, we just want to look better with less fat on our bodies (Dieting just happens to be a rather uncomfortable means to this end). All of this raises the question – ‘have we been led to overlook the simplest form of reducing calories and losing weight - short periods of fasting - in an effort to keep us consuming?’ The answer seems to be a resounding ‘Yes!’ Eat Stop Eat 28 Forget Everything You Have Ever Read About Fasting The amount of anti-fasting misinformation that can be found on the Internet is astounding. This is despite the fact that our bodies were designed to fast, and that almost every major religion and culture has some sort of fasting built into its rituals to this day, and that most scientific studies that require blood collection also require their subjects to be fasted. Information on fasting and dieting is prevalent in cyberspace and in popular diet books. However, this information should be read with extreme caution. Ridiculous statements such as “Fasting will KILL your metabolism,” “fasting deprives your body of nutrients and does nothing to help you modify your dietary habits,” “The weight loss from fasting comes entirely from muscle,” or “The weight loss from fasting comes entirely from water” and finally “If you do not eat every 5 hours your liver releases sugar, which causes an insulin surge making you gain fat even without food” are typical of the fasting misinformation that is available. This is an example of ‘authoritative parroting’ where people simply repeat what they have had heard from authorities on the topic, without actually stopping to check and see if what they have heard is correct. So the same misinformation is passed on, regurgitated, repeated, and made true; solely on the basis of the source, rather than whether or not it is actually correct. Eat Stop Eat 29 Other incorrect but often repeated statements include the notion that you will become hypoglycemic (have low blood sugar) if you do not eat every two to three hours and that fasting will prevent your muscles from growing. Typically, these statements are followed by more of the same old nutrition mantra “eat multiple small meals a day,” eat “high protein foods every two to three hours,” “avoid milk and dairy products,” and all the other popular ideas about dieting. The amazing thing is almost all of the scientific research I reviewed provided evidence in direct opposition to the misinformation found in diet books and on the Internet. I found very convincing evidence that supports the use of short term (as brief as 24 hours) fasting as an effective weight loss tool. This included research on the effect that fasting has on your memory and cognitive abilities, your metabolism and muscle, the effect that fasting has on exercise and exercise performance, and research that very conclusively exposes the myth of hypoglycemia while fasting. What made this even more interesting is that this type of fasting not only helps you lose weight, but also vastly improves many markers of health and comes with a very impressive track record. After all, outside (and inside) of North America, millions of people have been using intermittent fasting for centuries. As cutting edge as it may seem, taking brief breaks from eating is hardly anything new. It’s just something that a lot of people have been trying very hard to keep you from realizing! In fact, many people stumble onto fasting when they very first attempt to lose weight, and they usually see some success. They only give up on fasting after being convinced that it is bad and wrong by anti-fasting propaganda. Eat Stop Eat 30 From a marketing stand point fasting is boring. It does not have a sexy marketing angle and it certainly does not do anything to improve the bottom-lines of food companies. In this day and age, a diet has to have a hook or a catch. It needs something to make it different and special, and this typically involves some special way of eating, but never a special way of NOT eating. Here is the common sense reason why fasting may work better for you than any other diet you have ever tried: Think of all the diet rules you have seen lately. It might be something that says you need to eat your carbs separately from your fats, or that you need to eat zero carbohydrates all together. Maybe it’s that you need to eat all fat or that you need to cycle your carbohydrates or your protein. Perhaps it’s the idea that you must only eat raw foods or organic foods, or it’s a diet planned around a hormone like ghrelin, adiponectin, leptin, estrogen or testosterone...etc and etc and etc. Now consider this: If these rules were ACTUALLY true, then Lap Band surgery would not work. But it does, and it works very well.10,11 During lap band surgery, a small silicon band is placed around the top portion of a person’s stomach, effectively making your stomach ‘smaller’. It’s a very drastic step that involves a surgical operation, but nonetheless it is extremely effective at helping people lose weight simply because it makes people eat less. Not just less carbs, or less fat, but less everything. No periodic refeeds. No cycling. No crazy food combining. They simply eat less. Eat Stop Eat 31 The bottom line is that a diet really does NOT need a catch to be effective. In fact, I would argue that the less complicated a diet is, the better its chances of helping you obtain long lasting weight loss. The specific type of fasting I am about to describe is not just a tool for weight loss, but rather could be considered a fairly simple (yet effective) lifestyle adjustment that can help you lose weight and improve your health WITHOUT having to resort to special ‘rules of eating’, taking pills or powders or electing for invasive surgery. Eat Stop Eat 32 Fasting and your Metabolism In my review of fasting, I found some very interesting information, most of which contradicts much of today’s accepted ‘rules of nutrition’. Most startling is the fact that being in a fasted state for short periods of time will not decrease your metabolism. If you have followed any of today’s popular diets, you may know that they are all based on this idea. The story they are telling goes like this: If you lower your calories too much, even for a short period of time, then you will stop losing fat because your body has entered ‘starvation mode’ and your metabolic rate will slow to a standstill. In fact, this statement could very well be the basis for today’s weight loss industry. However, it turns out that it is factually incorrect. Our metabolism, or more correctly our metabolic rate, is based on the energetic costs of keeping the cells in our bodies alive. For example, let’s say we put you in a fancy lab and measured the amount of calories you burned in one day sitting on a couch doing nothing. Let’s assume that number was 2,000 calories. This would be called your basal metabolic rate; 2,000 calories would be the amount of calories you need to eat to match the amount you burn simply being you. Now, let’s say you moved around that day, perhaps 30 minutes of walking. You might burn an extra 100 calories bringing your daily total number of calories burned up to Eat Stop Eat 33 2,100. Your basal metabolic rate is always 2,000, and then any extra energy you expend moving your body (such as when we exercise) is added to that number. So in this example, you are going to burn 2,000 calories per day no matter what you do. So why are we being told that our metabolism will slow down if we do not eat for an extended period of time? The answer lies with an interesting metabolic process of eating called “The thermic effect of food”, and some clever interpretation of this rather simple process. The act of eating can increase your metabolic rate by a very small amount, and this is what is referred to as ‘the thermic effect of food’. This increase in metabolic rate is a result of the extra energy your body uses to digest and process the food. It takes energy to break down, digest, absorb and store the food once you eat it. This ‘energy cost’ has been measured in laboratory settings and is part of the basis for popular diets that promote the metabolic cost of one nutrient over another. For example, it takes more calories to digest protein than to digest carbohydrates or fats, so some diets recommend substituting some protein for carbohydrates and fat assuming this will burn more calories. Although this is scientifically true, the amount of extra calories this dietary change will cause you to burn is very small and will hardly make a difference to your overall calories burned in any given day. As an example, the idea of eating an extra 25 grams of protein so you can burn more calories can appear somewhat ridiculous. If you eat an additional 25 grams of protein, you would be adding 100 calories to your diet just so you can burn 10 more calories! The more logical approach would be to just not eat those 100 calories. Eat Stop Eat 34 Almost all of the calories you burn in a day result from your basal or resting metabolic rate (the calories it takes just to be alive). Beyond that the only significant way to increase the amount of calories you burn in a day is to exercise and move around. The research on metabolic rate and calorie intake is remarkably conclusive. I was easily able to find the following research studies that measured metabolic rate in people that were either fasting, or on very low calorie diets: In a study conducted at the University of Nottingham (Nottingham, England), researchers found that when they made 29 men and women fast for 3 days, their metabolic rate did not change.12 This is 72 hours without food. So much for needing to eat every three hours! In another study performed at the Pennington Biomedical Research Center, men and women who fasted every other day for a period of 22 days experienced no decrease in their resting metabolic rate.13 In addition, a study published in 1999 found that people who were on very low calorie diets and on a resistance exercise program (i.e. lifting weights) did not see a decrease in resting metabolic rate, and these people were only eating 800 Calories a day for 12 weeks!35 In another interesting study published in the aptly-named journal ‘Obesity Research’, women who ate half the amount of food that they normally eat for three days saw no change in their metabolism, either.14 In still more studies, performed on men and women between the ages of 25 and 65, there was no change in the metabolic rate of people who skipped breakfast, or people who ate two meals a day compared to seven meals per day.15,16 Eat Stop Eat 35 In a study published in 2007, ten lean men fasted for 72 hours straight. At the end of their fast their energy expenditure was measured and found to be unchanged from the measurements that were taken at the beginning of the study17 - Yet another example showing that fasting does not decrease or slow one’s metabolism. The bottom line is that food has very little to do with your metabolism. In fact, your metabolism is much more closely tied to your bodyweight than anything else. And, specifically of your body weight, your metabolism is almost exclusively tied to your Lean Body Mass. This means all the parts of your body that are not body fat. The more lean mass you have, the higher your metabolism, and vice versa. It doesn’t matter if you are dieting, dieting and exercising or even following a VERY low calorie diet. As the graph below illustrates, it is your lean body mass that determines your metabolism. Eat Stop Eat 36 The only other thing that can affect your metabolism (in both the short term and longer term) is exercise and movement. Even in the complete absence of food for three days, your metabolism remains unchanged. I find it troubling that every physiologist, medical doctor, and PhD that I have talked to seems to understand this, but many of the personal trainers, nutrition personalities and supplement sales people are completely unaware of this scientific fact. This is truly a testament to the amazing power and persuasive nature of the marketing that can be found on the Internet and in fitness and nutrition magazines. It is also an illustration of the scientific illiteracy of many of the fitness personalities and marketers you may deal with in your life. This got me thinking that, if short-term changes in food intake has no effect on metabolic rate, what other myths have I been led to believe as scientific facts? I took it upon myself to examine the science behind many of today’s popular diets. I found no difference between any of them in their effectiveness over the long term. People choosing higher protein, lower carbohydrate diets (similar to Atkins or The Zone) tended to see slightly better weight loss, at least in the short term. However, when these studies extended to more than six months and up to a year, the differences tended to even out.18 I found only one thing to be consistent with all of these diets. This common finding is the success of any diet can be measured by how closely people can follow the rules of the diet and how long they can maintain caloric restriction. Eat Stop Eat 37 In other words, a diet’s success can be measured by how well they can enforce my first nutrition ‘truth’ – ‘prolonged caloric restriction is the only proven nutritional method of weight loss’. If the diet plan allows you to stay on the diet for a long period of time, then you have a very good chance of achieving sustained weight loss success. From what we have seen, there is a large amount of science that supports the use of short term fasting as an excellent way to create a dietary restriction, and it seems to be an effective and simple way to lose body fat (which is ideally the goal of ANY weight loss program). On top of that we have also determined that short term fasting does not have a negative effect on your metabolism. So far, so good. Fasting does not cause any negative or damaging effects on our metabolisms, but that still leaves us with another big unanswered question: What type of effect does short periods of fasting have on our muscles? Eat Stop Eat 38 Fasting and Exercise Your muscle cells have the ability to store sugar in a modified form called glycogen. The interesting thing about this process is that your muscles lack the ability to pass this stored sugar back into the blood stream. In other words, once a muscle has stored up some glycogen, it can only be burned by that muscle and cannot be sent off for use by other parts of your body. For example you’re the glycogen stored in your right leg muscles can only be used by your right leg muscles. It cannot be donated to your liver, brain or any other part of your body. This basic rule goes for all of your muscles. This is in contrast to how your liver works. Your liver stores glycogen specifically for the purpose of feeding your organs, brain, and other muscles as needed. During a period of fasting, the systems of your body are relying on fat and the sugar that is stored in your liver for energy. Your muscles still have their own sugar that they need for exercising. The sugar in your muscles is used up quickly during high intensity exercises like weight training and sprinting, but even a few consecutive days of fasting in the absence of exercise has little effect on muscle glycogen content.19 By doing so, your muscle glycogen is truly reserved for the energy needs of exercise. Generally, research has found that any effect that brief periods of fasting has on exercise performance is small. Research completed in 1987 found that a three and aEat Stop Eat 39 half day fast caused minimal impairments in physical performance measures such as isometric strength, anaerobic capacity or aerobic endurance.20 In plain English, they found that a three-day fast had no negative effects on how strongly your muscles can contract, your ability to do short-term high intensity exercises, or your ability to exercise at moderate intensity for a long duration. More research published in 2007 found that performing 90 minutes of aerobic activity after an 18-hour fast was not associated with any decrease in performance or metabolic activity.21 What makes this study even more interesting is not only was fasting being compared to the performance of people who had recently eaten, but it was also being compared against the performance of people who were supplementing with carbohydrates during their workouts! This means fasting does not negatively affect anaerobic short-burst exercise such as lifting weights, nor does it have a negative effect on typical ‘cardio’ training. Another study published in the Journal of Applied Physiology in 1988 found no change in measures of physical performance when soldiers were exercised until exhaustion either right after a meal or after fasting for three and a-half days.22 From this research we can see that you should be able to work out while fasted and not see any change in your performance. The only situation where I think there may be a negative effect from fasting is during prolonged endurance sports, like marathons or Ironman-style triathlons, where you are exercising continuously for several hours at a time.23,24 These types of ultra-long competitions typically require the athletes to eat during the actual event in order to maintain performance over such prolonged time periods. Eat Stop Eat 40 In most research trials examining the effects of fasting on prolonged endurance activities it was found that fasting negatively affected both overall endurance and perceived exertion.25 Keep in mind, however, that many of these studies were performed at the END of a 24-hour fast.26 So it is not advisable to partake in a 3.5 hour bike right at the end of a 24-hour fast, but I’m hoping you already knew that. It should be noted that the “negative effect” that occurs from fasting before a long endurance activity only affects an athlete’s time until exhaustion (performance duration). So the amount of time an athlete can exercise while fasted before becoming exhausted is less than the amount of time it takes for a fed athlete to become exhausted. Even though fasting may decrease the amount of time it takes for an athlete to become exhausted, fasting actually has other positive effects, one of them being fat burning. Athletes performing long endurance activities while fasted actually burn more body fat than athletes who are fed (because the fed athletes are burning through food energy before they get to the stored energy in their body fat). So depending on your goals, fasting before endurance exercise may actually be beneficial (so much for the idea that you absolutely need to eat a small meal before working out – this completely depends on your exercise goals). Outside of these performance-based issues, I see no reason why you cannot exercise while you are fasting. The obvious ‘anecdotal’ issue would be concerns about exercise during fasting being able to cause low blood sugar levels. However this has been addressed in research conducted on experienced long distance runners. In a study published in 1986, nine men who were experienced long distance runners were asked to run at 70-75% of their V02 Max for 90 minutes (this is a pace and Eat Stop Eat 41 distance that most recreational, gym-going people could never achieve). They completed this run twice. Once while in the fed state, and a second time a couple of weeks later when they were at the end of a 23-hour fast. Surprisingly, when the blood glucose levels of the runner’s first run and second run were compared, they found no difference between blood glucose levels during the two 90-minute runs. Not only this, but the fasting run also resulted in higher rates of fat burning. It also took almost 30 minutes of exercise in the fed-state before the runner’s insulin levels finally fell to the same levels that they had BEFORE they even started their run when they were in the fasted-state.27 In other words, after 23 hours of fasting, the runners insulin levels had dropped down to the same levels you would have after 30 minutes of intense running. From a health point of view, that’s a pretty amazing head start! Eat Stop Eat 42 Here is another interesting benefit of exercise while fasting. There are metabolic pathways that actually help maintain your blood glucose and glycogen levels while you are fasting, and exercise has a positive effect on these pathways. During high-intensity exercise your muscles produce a bi-product called ‘lactate’ (sometimes referred to as lactic acid). Lactate has been wrongfully accused of causing the pain in your muscles when you workout, and something called Delayed Onset Muscle Soreness - the pain you feel days after your workout. While lactate doesn’t cause pain, it does help maintain your blood glucose and glycogen levels while you fast. When lactate levels build up in your muscles as the result of exercise it can leave the muscle and travel to the liver where through a process called gluconeogenesis (making new glucose) it is associated with recovery of glycogen stores. So exercise can help maintain blood glucose levels and glycogen stores while a person is fasting.28 In fact, it’s not only lactate that helps to maintain your blood glucose and glycogen levels while you fast. The very act of burning fat also releases something called ‘glycerol’ from your body fat stores. The free fatty acids in your fat stores are ‘attached’ to something called glycerol while it is stored in your body fat. When the fatty acids are released, so is the glycerol. (Three fatty acids attached to a glycerol ‘back bone’) Eat Stop Eat 43 Glycerol is a valuable precursor for gluconeogenesis in the liver. So the very act of burning fat can also help maintain blood glucose and liver glycogen stores. And, since low intensity exercise tends to increase the rate of fat release and the amount of fat being burned as a fuel, you could say that both high-intensity and low-intensity exercise actually help to make you fasts ‘easier’ by helping to regulate your blood sugar levels, and supply building blocks to help maintain your glycogen levels. I believe the perceived need to eat before a workout or a strenuous activity is more of a psychological need than it is a physical need. Fasting has little to no effect on most forms of exercise, and exercising while fasting may actually make your fast feel easier by helping to maintain blood glucose levels and glycogen stores. Fasting is not advised preceding long-length endurance events, or during the training of elite athletes if the training involves multiple workouts each day, and where performance is the number one priority over body composition. But for everyone else the combination of fasting and exercise may be a potent way to lose body fat and maintain muscle mass. Eat Stop Eat 44 Fasting and your Brain I think this myth may not be the fault of the nutrition industry as much as it is a carryover from our childhood. The idea that we must eat to fuel our brains may in fact be true for children, as research seems to suggest that children do better in basic school tests after they have had breakfast as opposed to when they skip breakfast.29 This makes sense, as children are still growing and developing, but is it true for adults too? As it turns out, the research doesn’t really support the idea that you get ‘dumb’ or ‘slow’ when you haven’t eaten for a couple of hours. In a test where twenty-one university aged people were asked to perform a series of intellectual tests after having either a normal meal, skipping one meal, skipping two meals or going 24 hours without food, researchers found no difference in performance on measures of reaction time, recall, or focused attention time.30 This led the authors of the study to conclude that short-term food deprivation did not significantly impair cognitive function. These results have been confirmed in additional studies where healthy young adults ate as little as 300 calories over a two day period and experienced no decrease in tests of cognitive performance (including vigilance, reaction time, learning, memory, and reasoning), activity, sleep, and mood.31 Eat Stop Eat 45 The interesting part was that in earlier research the exact same group of scientists found that when people were dieting for prolonged periods of time, they found the exact opposite results. They discovered that prolonged dieting did cause a slight decrease in cognitive function.32 So while long-term self-deprivation may result in a lower ability to concentrate, it seems that short-term fasting doesn’t have this effect. This leads researchers to suggest that the effect of long-term dieting on cognition may be more psychological than it is physiological. Basically, when you are dieting for a prolonged period of time you perform worse because you tend to be grumpy and miserable or because you are unsatisfied with your body.33 Whatever the reason, the research illustrates that short-term fasting, especially the method described in this book, doesn’t produce this effect. Not only has research shown that short-term fasting doesn’t impair cognitive function, but it also suggests that long-term calorie restriction may improve memory in older populations. When researchers put a group of 50 women with an average age 60.5 on a calorie reduced diet for three months they found that the women had significantly improved scores on verbal memory tests.34 So not only does fasting not impair your memory function, it may even improve your memory in the long run. And, as we discuss in later chapters, new research on fasting is currently uncovering a brain-protecting mechanism that is turned on by fasting (see the chapter on Cellular Cleansing). Yet another myth about fasting has proven false. Eat Stop Eat 46 Fasting and your Muscle Mass The other great myth about dieting and fasting is that you will lose your muscle mass while you diet. Based on the available research, this is completely false. Preserving muscle mass seems to be a very important thing in the diet industry right now and for good reason. Muscle makes up a large proportion of your lean body weight, and for this reason muscle is a large contributor to the amount of calories you burn in a day. While the idea that muscle burns massive amount of calories is a bit of stretch (every pound of muscle on your body only burns about 5 calories per day, not 50 like commonly stated), the fact that you can build or lose muscle makes the metabolic contribution of muscle very important. Not only that, you cannot deny the effect that muscle has on your body image. Being lean AND having muscle definition typically makes people feel good about themselves. Luckily, not only does reducing your caloric intake not cause your metabolism to slow down, it also does not result in a loss of your hard-earned muscle. There is one imperative rule that goes along with this statement: You have to be involved in some sort of resistance exercise, such as lifting weights. Now, to be clear, you do not have to weight training at the exact same time you are fasting, but Eat Stop Eat 47 both resistance training must be occurring at some point for your muscle mass to be preserved in the face of a caloric deficit. While long term caloric restriction on its own can cause you to lose muscle mass (such is the case with hospital patients who are on a low-calorie diet and confined to bed rest), the combination of caloric restriction with resistance exercises has been proven to be very effective at preserving your muscle mass. Research published in 1999 found that when men and women followed a 12 week diet consisting of only 800 calories and around 80 grams of protein per day, they were able to maintain their muscle mass as long as they were exercising with weights three times per week.35 In another study published in 1999, obese men restricted their caloric intake by eating 1,000 calories less per day than they normally ate for 16 weeks. They took part in a weight-training program three days a week and were able to maintain all of their muscle mass while losing over 20 pounds of body fat!36 In yet another study, 38 obese women undertaking a reduced-calorie diet for 16 weeks were also able to maintain their muscle mass by training with weights three times per week.37 As long as you are using your muscles, they will not waste away during short periods of dieting. From my experience in the sports supplement industry, I can tell you that drug-free bodybuilders and fitness athletes constantly undergo 16- to 20-week periods of very-low-calorie diets while maintaining all of their muscle mass as they prepare for bodybuilding contests. The muscle preserving effects of exercise are even evident in older populations. When 29 men and women between the ages of 60 and 75 dieted for 4 months, the group that Eat Stop Eat 48 was exercising experienced no significant decrease in lean mass, while the group that was not exercising had more than a 4% decrease in lean body mass.38 Even more good news comes from the fact that your weight workouts don’t have to be painfully long to be effective. When forty-four overweight women performed a 30- minute weight training workout three days per week for twenty weeks while following a low-calorie diet, they were able to lose almost 5% body fat while maintaining all of their lean body mass.39 Finally, research has clearly shown that fasting for as long as 72 hours (regardless of whether or not you are exercising) does not cause an increased breakdown in your muscle, nor does it slow down muscle protein synthesis.40,116 Another diet myth busted! Fasting and low calorie diets DO NOT cause you to lose muscle mass if you are resistance training. In fact, as we will discuss in the Fasting and Inflammation chapter, fasting may actually decrease some metabolic factors that are actually preventing you from building muscle. And, as we will discuss the Cellular Cleansing chapter, fasting may perform critical maintenance and ‘clean up’ work in your muscle that properly prepares it for extra growth. So in the long-term, fasting and weight loss may actually improve your ability to build muscle mass! So much for the so-called starvation mode or needing to eat protein every couple of hours - the key to maintaining your muscle mass long-term is resistance exercise; your diet has almost nothing to do with it! And since your diet has very little to do with your muscle mass, short periods of fasting definitely will not cause your muscles any harm (especially if you continue to work out regularly) and may even help you build muscle in the long term. Eat Stop Eat 49 A note on Fasting and Increasing Muscle Size While the research is very clear that fasting for 24 hours will not cause you to lose muscle, it does not address the issue of whether or not fasting can impede muscle growth. The process of muscle growth is still a vague collection of physiological phenomena that is not completely understood. What we do know is that muscles respond to certain types of mechanical stress by being damaged, repairing themselves and, under the right circumstances, increasing in size and capacity to generate force.41 There seem to be two basic nutritional requirements to ensure muscle growth occurs: 1) Caloric Adequacy 2) Protein Adequacy You’ll notice that the first point is caloric adequacy and not caloric surplus. While the common belief that you need to ‘eat big to get big’, recent research has shown that any extra calories above your estimated daily needs does not contribute to muscle gain. In fact, almost every single extra calorie can be accounted for in fat mass gains42. So while there is an obvious caloric need for muscle building it does not seem to be any higher than your daily calorie needs (building muscle does take energy, but it also happens very slowly). This is where Eat Stop Eat may actually be BETTER than traditional dieting for muscle gains. With Eat Stop Eat you are only in a calorie deficit for one or two 24-hour periods per week. The rest of the time you can eat to maintenance if you choose to. This is in Eat Stop Eat 50 direct contrast to traditional dieting where you may spend months in a constant calorie deficit. While the speed of muscle growth is very slow, the unique ability to have periods of calorie restriction and calorie adequacy do supply a sound theory as to why intermittent fasting may be a superior choice for people looking to build muscle while losing body fat. Especially since there is a small but interesting amount of evidence to suggest that fasting can actually prime the metabolic machinery to be more sensitive to the anabolic effects that protein intake43,44 and exercise45 have on muscle growth. While protein intake is also a hotly debated topic, I have found through my review of the existing research that intakes above the current recommended daily intakes does seem to aid in muscle growth and that any protein containing meals consumed within 24–48 hours following a resistance exercise session will contribute to muscle growth.46 Also, new research suggests that skeletal muscle protein synthesis responds better to intermittent pulses of protein rather than a continuous supply44. It is speculative, but intriguing, to suggest that a 24-hour break once in a while may even be able to aid in the muscle building process. To summarize, periods of caloric adequacy, combined with an adequate protein intake and the proper stimulus, seem to be enough to allow for muscle growth. And intermittent fasting may actually allow for better muscle growth than long-term continuous caloric restriction. Eat Stop Eat 51 A Final Thought on Fasting and Muscle Mass While long term caloric restriction on its own can cause you to lose muscle mass, the combination of caloric restriction with resistance exercises has been proven to be very effective at preserving your muscle mass. As long as you are consistently using your muscles in a progressive and challenging manner, they will not waste away during short periods of dieting. Further, muscle mass can be preserved during longer periods of calorie restriction, so long as resistance training is part of the overall weight loss approach. Finally, intermittent fasting may provide a novel and unique method of increasing muscle size while at the same time reducing body fat. The above pictures are of me in 2006 while working in the supplement industry, (29 years old, 170 pounds); in 2009 after 3 years of following Eat Stop Eat (32 years old, 176 pounds); and lastly in 2012 after 6 years of following Eat Stop Eat (35 years old, 173 pounds). Hopefully you’ll agree that I have not suffered massive muscle loss and may have even built some more muscle after 6 years of following Eat Stop Eat. Eat Stop Eat 52 Fasting and Hunger The true feeling of real hunger is difficult to explain and I’m not sure many of us have ever really experienced it. We have felt the withdrawal of not being able to eat when we wanted to, and the disappointment of not being able to eat what we wanted to, but true hunger is reserved for those who have gone weeks without eating and are not sure when or where their next meal will come from. Consider that most people get noticeably hungry or irritated if they have gone more than two to three hours without eating. But during this time, metabolically speaking, they are still in the fed state. This means their bodies are still processing the food they ate at their last meal. There is still unused energy from their last meal in their system, yet they are already feeling hungry enough to eat again. How can this be? Most likely, what we call hunger is really a learned reaction to a combination of metabolic, social and environmental cues to eat. Remember how I mentioned that the food industry spends 10 billion U.S. dollars per year advertising food? Well, it turns out that this advertising is very effective. According to Brian Wansink, author of “Mindless Eating” and dozens of scientific publications on ‘why people eat’, we make as many as 200 food related decisions every day and are subjected to countless food advertisements.47 In my opinion, this is why almost all diets fail. It is virtually impossible for us to always be consciously in Eat Stop Eat 53 control of what we eat and how much we eat. There are just too many environmental factors (like advertising and fast food availability) that are working against us! The role of taste and smell in motivating a person to eat (and in the foods they select to eat) is fairly obvious. Perhaps less obvious is the role of habit, social influence and cephalic reflexes. For the most part, I believe that hunger as you and I understand it is a conditioned response created through the mix of tastes, smells, habits, and social influence. In other words our desire to eat is determined by a combination of our body’s response to the amount of food we have eaten, and our mind’s response to all of the environmental factors around us (such as TV commercials and snack food packaging colors, fonts and graphics.) While it is easy to suggest that ‘hunger’ and ‘cravings’ are purely learned phenomena, developed from infancy until we are adults, others argue that hunger is actually more of a biochemical phenomenon. It has been argued that our constant desire to eat may even be related to a form of addiction. In the best selling diet book, “The South Beach Diet”, author Dr. Arthur Agatston refers to our love of sugar as our ‘Sugar Addiction’.48 He may have been on to something with that statement. According to a recent article in Scientific American Mind, by psychiatrist Oliver Grimm, recent research suggests that drug addiction and binge eating are very similar in ‘neurobiological terms’.49 Put more simply, the brain reacts to food (not just sugar) the same way it would react to a hardcore narcotic like cocaine. In another article from Scientific American, Nora D. Volkow, Director of the National Institute of Drug Abuse stated that food and illicit drugs both excite areas of the brain Eat Stop Eat 54 that are involved with reward and pleasure. Therefore, food can create a conditioned response that is evoked by the mere sight of food, or even by being in an environment in which these foods are consumed.50 While explaining food cravings and hunger in this purely biologically manner is intriguing – especially the connection between the psychoactive compounds in food and hunger, these concepts seem to be based more on speculation that substantial research findings.51 In reality, the total body of research seems to suggest that there are both biological and learned influences on appetite, and that these two influences are highly intertwined and probably cannot be separated. Evidence from a wide variety of sources supports the idea that eating motivation is not regulated according to a simple cycle of ‘depletion and repletion’, but rather a series of motivational effects of the presence of food, its taste, smell, palatability, and a whole host of other external cues. Within the last decade, it has been recognized that an increasing proportion of human food consumption is driven by pleasure, known as ‘hedonic hunger’.52 And this hedonic hunger creates many of our learned eating habits. In other words, it is the way that we eat each day that ‘teaches’ our body when to expect food, and even what kinds of foods to expect. The exact term for this phenomenon is ‘food entrainment’. In animal studies we refer to the reaction to food expectation as ‘food anticipatory activity’. And this isn’t just a ‘psychological’ thing (it’s not just ‘all in your head’). Eat Stop Eat 55 Food anticipatory activity includes increased locomotor activity, body temperature, corticosterone secretions, gastrointestinal motility, insulin secretion, and activity of digestive enzymes.53,54,55,56 So we truly can ‘teach’ our bodies when and where to be hungry. And, because much of hunger is a learned phenomena developed from infancy to adulthood, the desire to eat specific foods in particular contexts (celebration) or in relation to particular feelings (stress foods) or situations (beer while watching football) can be regarded as a feature of normal appetite, rather than being an indication of some sort of eating pathology like an addiction or dependence. It is simply ‘how we learned to eat’. In fact, it is mostly social factors that teach us which of these learned ‘hungers’ is right or wrong. The desire to eat eggs at breakfast time and the desire to eat chocolate when relaxing and watching television in the evening may both be examples of specific learned appetites. However, only one of these learned appetites would be viewed as an addiction or craving. In this sense, eating things you don’t want to eat, or that don’t move you towards your goal is nothing more than bad habit that has been learned and ingrained through years and years of practice. From my own personal experience with fasting, I can tell you that you do get used to the feeling of not eating, and not worrying when you will be eating your next meal. It becomes easier to manage as your body gets used to the feeling of having a truly empty stomach. Eat Stop Eat 56 I am not certain if this is because you switch from fed to fasted at a quicker rate, or if it is just getting used to having an empty stomach, or if you are ‘unlearning’ your typical eating habits. Another possibility is that by learning the truth about fasting you get rid of the guilt you used to get when you thought you were doing something unhealthy by not eating every couple of hours. Whatever the case may be it does get easier. Even when you do feel hungry while fasting, the hunger sensations usually don’t last more than a few minutes. Friends of mine who have adopted periods of fasting into their lives have reported a sense of freedom during the day, mostly because they do not have to spend time worrying about what and when to eat or the emotional stress of choosing appropriate foods. There is a definite feeling of being ‘free’ from many of our previously held ‘hunger cues’, and this allows us to develop a much clearer understanding of what it takes to identify and control the reasons why we eat. Often times, periods of fasting have been associated with being more alert, ambitious, competitive, and creative. Not only that, but you are no longer having to continuously plan your day around the timing of your next meal, and you may be ‘resetting’ your body’s expectation of when and how much you are going to eat. Essentially, taking short breaks from eating allows you the opportunity to retrain your food anticipatory activity to allow you to eat less even on the days when you are not fasting. Lastly, people are also often concerned that fasting will ‘make them hungry’. Luckily, this concern can be addressed by research that studied the calorie intake of people after a 36-hour fast. Eat Stop Eat 57 This research found that a 36-hour fast does not cause you to rebound and eat significantly more calories once the fast has been broken. Fasting for 36 hours tends to lead to a slightly larger breakfast the next day, possibly causing a 400 calorie increase for the day.57 This may sound extreme, but keep in mind the 36-hour fast caused an average of 2800 calories worth of deficit, so even with 400 extra calories at breakfast the next day, there was still a total deficit of 2400 calories. If you like the ‘glass half full perspective – a 36-hour fast created a 2,400 calorie deficit AND allowed for an extra big breakfast the next day! The bottom line is that fasting allows people to unlearn some eating habits, or at the very least become aware of some of the key cues that cause them to overeat, and short-periods of fasting do not induce a powerful or uncontrolled need to compensate on the subsequent day by vastly overeating. Eat Stop Eat 58 Fasting and Blood Sugar Levels I’m guessing that at some point in your life you have heard someone say they are ‘hypoglycemic’ or that they have ‘low blood sugar’. Typically, this is used as part of the reason why this person needs to eat every couple hours to keep their ‘blood sugar stable’. The basic story is that if they don’t eat every three or four hours then they become hypoglycemic and become irritable, moody, light-headed and shaky. I find this an interesting phenomenon considering as little as 5-10% of the population actually have a malfunction in their ability to regulate their blood sugar levels. Also, there is no actual clinical consensus regarding the cut-off values for blood glucose levels that truly define hypoglycemia for all people and purposes. It’s important to note that I am not suggesting that hypoglycemia does not exist. I am merely suggesting that the average person without an underlying medical condition does not have to worry about getting ‘low blood sugar’ while they are fasting. From reviewing the research it is evident that unless you have drug-treated diabetes, hypoglycemia just isn’t that prevalent in healthy people. This is because your body is amazingly effective at regulating the amount of sugar that is flowing around in your blood.58 Eat Stop Eat 59 Throughout the typical 24-hour cycles of eating, digestion, and fasting, the amount of glucose in your blood is generally maintained within a range of 70-140 mg/dL (3.9-7.8 mmol/L) as long as you are healthy. To give you an idea of how truly remarkable this feat is, consider the following: the average human being has about 5 liters of blood. Looking at the numbers above and doing some quick conversions we realize that during any given day, the amount of sugar in your blood ranges from between 5 grams and 7 grams. This is roughly the amount of sugar in one to one-and-a-half teaspoons! Research conducted upon healthy adults shows that mental efficiency declines slightly (but measurably) as blood glucose falls below about 65 mg/dL (3.6 mmol/L), or into the range of about one-half of a teaspoon. It is important to note that the precise level of glucose considered low enough to be defined as hypoglycemia is dependent on the age of the person, the health of the person, the measurement method, and the presence or absence of negative symptoms. According to the research I reviewed on the effects of short-term fasting on blood sugar, a 24-hour fast should not place you into a hypoglycemic state,59 and I have not seen any research that has shown a subject going below 3.6 mmol/L blood sugar during a short-term fast. So if there isn’t any clinical evidence of short-term fasting causing hypoglycemia, what’s with all these people who say they get moody and light headed if they don’t eat every three hours? In a paper titled “Effect of fasting on young adults who have symptoms of hypoglycemia in the absence of frequent meals” researchers aimed to answer this exact question. Eat Stop Eat 60 Specifically, the researchers were interested in the glucose metabolism of subjects who had a history of what they considered to be hypoglycemic episodes (becoming irritable or feeling ‘shaky’ in the absence of food). Eight people who reported a history of hypoglycemic episodes were compared to eight people who have never experienced any form of hypoglycemia. Both groups completed a 24-hour fast while their blood sugar levels were monitored.60 During the study none of the subjects in either group had any periods of documented hypoglycemia. In fact, after closer investigation it was apparent that when the group that had a history of ‘hypoglycemia’ reported periods of ‘feeling hypoglycemic’ their blood sugar levels were at normal levels. Both groups had a decrease in insulin and an increase in body fat being used as a fuel during the 24-hour fast. The researchers concluded that there is no doubt that some people may find eating less to be more stressful than others, but as long as no other metabolic disease is present, the ability to maintain blood glucose in the normal range does not seem to be affected during a 24-hour fast. They then speculated that the symptoms of hypoglycemia could in fact be related to anxiety and stress over not eating, as opposed to being caused by low blood sugar. This anxiety could be over fear of becoming hypoglycemic, fear that they are doing something unhealthy by not eating, or even a drug-like withdrawal response to not being able to eat when they wanted to. Eat Stop Eat 61 For whatever reason these feelings occur, the research seems very clear that while some people find eating less a little more stressful than others, short-term fasting will not cause you to become hypoglycemic*. * Keep in mind that Eat Stop Eat is written for people without any underlying medical conditions. If you have diabetes or any other condition, please consult with your doctor. Eat Stop Eat 62 Other Misconceptions of Fasting There were many other misconceptions about fasting that I found while reviewing books, magazines, and websites. Of course, I also found through studying the metabolic effects of fasting that without a single exception every one of these turned out to be misunderstood research, incorrect information, or just poor journalism. A great example of some of these misconceptions would be the effect that short periods of fasting has on the hormones leptin, testosterone, and cortisol, as well as the concern over missing breakfast. Leptin is a very interesting hormone. It gets lots of buzz in the weight loss industry, mostly because of its effects in animal research. In 1994, researchers discovered that a certain strain of genetically mutated obese mice had a deficiency of a certain protein-hormone called leptin, which is released from fat cells and is monitored by the brain. Whereas normal mice had a gene that causes fat cells to secrete leptin, these mutated obese mice lacked this gene. When these obese and leptin-deficient mice were injected with leptin, their weight slowly returned to non-obese levels.61 Shortly after this discovery it was found that leptin could even increase metabolic rate (energy expenditure) in mice. Eat Stop Eat 63 The weight loss industry quickly jumped on this story, and leptin was hailed as the cure for obesity. When I began my research I found the belief that ‘changing levels of leptin were of vital importance to a person’s fat loss efforts’ to be a troubling one. Mainly because even short-term fasting is known to dramatically reduce leptin levels. As it turns out, what works in mice, doesn’t always work in humans. It has since been found that when leptin levels are reduced by as much as 80% in humans there is no change in resting metabolic rate.62 Changes in leptin levels do not seem to have any influence on, nor are they influenced by, changes in resting metabolic rate in humans. In other words, when it comes to humans, leptin just doesn’t seem to have any effect on your metabolic rate.63,64 In humans, leptin does seem to be correlated to the amount of food we eat. The more food we eat, the more leptin in our blood stream. Overeating for several days can increase leptin levels; however, these levels return to normal within hours after the overeating is stopped.65 Leptin also seems to be correlated to the amount of body fat we have. The more fat we have stored, the more leptin tends to be circulating in our blood stream.66 However, research has shown consistently that there are substantial differences in the physiological actions of leptin between rodents and humans and this may explain why there is so much leptin-confusion in the diet industry.68 In humans, leptin rises and falls acutely in different situations, and these situations are often counter-intuitive to the idea that leptin is intimately tied to the amount of body fat you have or how much food you have been eating. Eat Stop Eat 64 As an example, both long-term endurance exercise and resistance exercise can cause reductions in leptin levels, as can fasting,62 increased testosterone levels,67 and increased catecholamine levels. Even injected anabolic steroids can decrease leptin levels.69 In all of these situations leptin levels drop very quickly, obviously too quickly to be a marker of the amount of body fat you have. In fact, in all of these examples there is an increase in fat burning, despite massive drops in leptin levels. Obviously there is more to the leptin story then we know to date. In fact, leptin is currently being studied for its role in regulating reproduction, maturation, and even its role in inflammation – specifically its pro-inflammatory role in chronic systemic inflammation.70 The bottom line is that leptin is an extremely important hormone that is intricately connected to the amount of fat you have on your body. It is tied to appetite regulation and may even be involved in the fat burning process, but it is not the ‘master regulator’ of fat burning that it has been made out to be by the fitness and supplement industries. And, while short term fasting typically involves an acute decrease in leptin levels, the consistent increase in growth hormone (GH) ensures that fat loss remains elevated during periods of fasting (more on this in the next chapter). So even with the ever-increasing scientific knowledge we are gaining about the importance of leptin, using short-term flexible intermittent fasting combined with resistance training remains one of the most effective and simple ways to lose weight and reduce your body fat. In fact, even when leptin is injected into fasting individuals it doesn’t improve fat burning or affect GH levels.71 Eat Stop Eat 65 Another myth about fasting is that it prevents muscle growth by decreasing testosterone levels. In both men and women, testosterone plays a key role in health and well-being as well as in the prevention of osteoporosis. It is largely responsible for determining how much muscle mass a man (and to a lesser extent a woman) possesses and also has positive effects on a person’s libido. Athletes often use testosterone in the form of anabolic steroids as a way to improve performance, build muscle and decrease body fat. It is considered to be a form of cheating in most sports. (The International Olympic Committee has banned testosterone doping). A common belief in some athletic circles is that short periods of fasting can cause your testosterone levels to plummet to almost non-existent levels. There are a number of reasons why I was skeptical when I first heard this claim, but the most obvious to me was that I had done extensive research on testosterone for a patent I was working on back when I was employed in the supplement industry. Consequently I knew that testosterone levels are actually highest during the morning after an overnight fast.72 These levels will be 20-30% higher than testosterone levels found during the evening. The relationship between testosterone levels and dieting has been explored in research. There is consistent evidence that mild caloric restriction (about a 15% calorie restriction) does not lead to reductions in testosterone or free testosterone in otherwise healthy males.73 Maybe more importantly, we do know from examining large scale (over 1,000 subjects) longitudinal studies (following people for around 8 years) that gaining body fat is correlated with lower testosterone levels, and having high body fat is also correlated with having low testosterone levels.74,75 Luckily, the very act of Eat Stop Eat 66 losing body fat is able to restore testosterone levels back to normal levels.76,77 Based on this research we know that being overweight, and even the act of gaining weight, is associated with lowered testosterone levels. Mild calorie restriction is not associated with any decrease in testosterone, and losing weight can return testosterone levels back to level that would be consider normal. However, the evidence behind severe calorie restriction suggests that long-term very-low-calorie diets may negatively affect testosterone. Research has shown that a group of men undertaking large-scale caloric restriction for extended period of time (~7 years) with no weight training do have lower testosterone levels then non-obese men who eat the normal American diet.78 There are a couple of points that need to be addressed with these findings. Firstly, the men following the prolonged calorie restriction diet had startlingly low levels of both fat mass and lean body mass. So it is unclear whether the drop in testosterone was a direct result of their diet, or the combination of their diet, lack of resistance training, and body composition. Secondly, their testosterone levels, while still lower than the typical men, were still within normal levels for their age. Interestingly, we can find some very convincing answers in military research. After eight weeks of extreme multi-stressor environments (very-low-calorie diet, super high energy expenditure, high temperatures and extreme lack of sleep – military training) testosterone levels can drop to almost castration levels. However, a slight refeed can rapidly restore testosterone levels, and testosterone levels end up higher five weeks after the eight week long stressful protocol.79 So extreme conditions including calorie deprivation can lead to reductions in testosterone, but what about fasting? After thoroughly reviewing the available research, I found that short-term fasting does not negatively affect testosterone levels. However, more prolonged fasts seem to be associated with slight decreases in testosterone levels. A 58-hour fast has been noted Eat Stop Eat 67 to cause reduced morning serum testosterone measurements by the third straight morning of fasting;80 as can fasting for 84 hours.81 These measurements, however, were still well within the normal range for healthy adults.82 In fact, other studies have found that it takes about nine straight days of fasting before a significant decrease in testosterone levels is observed.83 Research examining the effects of brief fasting (14-18 hours) over 21 days found that testosterone levels were not affected by almost a month of short-term fasting.84 These findings all point to the fact that short-term fasting does not have any negative effects on testosterone levels, and certainly would not cause serum testosterone levels to ever drop below normal. In fact, based on this evidence this may be one area where brief periods of fasting is actually better than prolonged dieting – since the short periods of fasting do little to disrupt testosterone levels. However, it should be noted that in the research where long-term fasting or diets with a high level of calorie restriction did cause a reduction in testosterone, it was found that when the fasting or dieting was ceased, testosterone sensitivity was increased, and higher ‘rebound’ levels of testosterone were observed.80,85,86 So far, so good. If we want to use short term fasting to lose weight we know we don’t have to worry about leptin or testosterone levels. And even if we decide to use longer term fasting (longer than 24 hours) we know that both leptin and testosterone levels will return to normal once the fast is completed. Finally, we have the myth of cortisol. Cortisol is a corticosteroid hormone, or glucocorticoid, produced by the adrenal cortex, which is part of the adrenal gland. It is usually referred to as the "stress hormone" as it’s involved in the response to stress and anxiety. It has many different actions in the body, but most people know of Eat Stop Eat 68 cortisol for its role in increasing blood pressure and blood sugar, and helping the body cope with stress illness and injury. Over the last couple years cortisol has been fingered as a culprit in causing obesity, specifically through a speculative link to belly fat. And, just like anything else that has been labeled 'bad' it has been rumored that if you don't eat every couple hours you would cause your cortisol levels to jump. This ‘jump’ has been associated with a whole host of problems other than increasing body fat, including the rumor that, “If you don’t eat every couple hours your cortisol will get very high and it will ‘destroy’ your muscle mass”. In direct opposition to the cortisol scaremongering we find in the media, the consistent finding in the research on fasting is that there is very little or no change in cortisol levels. This is especially true in a short 24- hour fast104 as well as after 72 hours of fasting.40 It has also been found that even two weeks of fasting every other day did not negatively affect cortisol levels.87 The funny thing is, we have known for more than four decades that increased cortisol is a phenomenon that is regularly found in obesity.88. And, we have also known that treating obesity with very low calorie diets causes a decrease in serum cortisol. So, being overweight increases cortisol, the actual act of fasting doesn't make it go up (at least when fasting for less than 72 hours), and losing weight will make it go down? Sounds like even more reason to fast for weight loss. The truly amazing thing is that while delving into these common nutritional myths I began to find more and more health benefits that are associated with taking brief breaks from eating. It seems that fasting can have many positive health effects beyond simply helping you lose weight and burn body fat. Eat Stop Eat 69 But what about Breakfast? Probably one of the biggest concerns people have when it comes to fasting (after worrying about their metabolism ‘crashing’) has to be the idea of missing a breakfast, and I can see why. For close to three decades now, nutritionists and nutritional texts have been recommending breakfast as an important part of healthy eating habits, often quoting the ‘most important meal of the day’ marketing mantra.89 There is one major problem with the idea of missing breakfast – it’s not actually possible. The reality is breakfast is the first meal of the day no matter when you eat it. After all, breakfast is a two part word “break” – “fast”. The meaning is literally ‘breaking a fast’. So by the purest definition of the word, your first meal after waking up, no matter how many hours after you wake up, counts as breakfast because this is the meal that “breaks the fast”. It is only for research and marketing purposes that breakfast is labeled as a meal that is eaten in the morning right after you’ve rolled out of bed. Of course, this still leaves us with questions such as ‘how long after waking up is my first meal still considered breakfast? Is it 30 minutes after waking up? One hour? Two hours? What if I’m a shift working and I start my day at 10pm? Does my first meal at 11pm count as breakfast? Of course none of these questions are answered in the scientific literature as the answers will not fit into the neat and tidy marketing story of what breakfast is supposed to be. Based on long term research it is true that people who regularly ate breakfast had a ‘better BMI’ and weighed less, and had less health risks, than those who regularly skipped breakfast.90. The problem is, however, the association of breakfast eating and Eat Stop Eat 70 weight is complicated by MAJOR lifestyle confounders. For instance, breakfast consumers were more likely than breakfast non-consumers to be older, female, white, nonsmokers, regular exercisers, and trying to control their weight. So people who are active and ‘health conscious’ tend to be the ones who eat breakfast. Which begs the question; – is this because eating breakfast is in fact healthy and promotes a healthy lifestyle, or is it because breakfast is currently being marketed as healthy and therefore those seeking to be healthier start eating breakfast? It is also likely that people with high BMI’s favor skipping breakfast in an attempt to lose weight.91 Despite the correlations between weight and eating trends and all the semantic arguments about what is and isn’t breakfast, we must look to research to find provide us with some evidence to help us rate the importance of ‘breakfast’, and to find possible mechanism that would account for breakfasts overall effect on health and weight. After reviewing the total body of research on breakfast, one thing becomes startlingly clear - the amount of food you eat at ‘breakfast’ is strongly correlated to your overall daily intake. Or put more simply - as calories consumed at breakfast go up, so does overall calorie intake for the day.92,93,94,95 The second thing that also reoccurs across multiple research studies is that the people who skip (delay) breakfast select more calorically dense foods later in the day than do those who regularly eat breakfast. The argument ‘skipping breakfast leads to eating more during the day’ is technically backed by research.96 At first glance this could seem as a major negative of delaying your first meal, however, the critical piece of information that usually fails to get reported is this same research shows the amount of 'extra' calories breakfast skippers eat at lunch and dinner is not enough to make up for the calories lost by skipping breakfast. Eat Stop Eat 71 In other words, even though breakfast skippers eat slightly more calories at dinner and lunch, they still on average eat less total calories over the entire day. So while skipping eating in the traditional ‘breakfast’ period may lead to eating more calories at other meals, the result is still typically a reduction in overall calorie intake. Thus we can conclude that skipping breakfast does not lead to eating more total calories.97 The other prevailing argument for the importance of breakfast is that skipping breakfast leads to increased snacking throughout the rest of the day. The typical warning against skipping breakfast is something like this: “The last thing anyone should do is skip breakfast. Otherwise, you'll be eating something even worse later on - candy bars and potato chips -- because you're starving." This is the ‘common thinking’ when it comes to breakfast. Skipping breakfast means eating ‘crap’ later in the day. So the question becomes, ‘is this true, and does it matter?’ When it comes to the benefits of breakfast and weight loss we can turn to the research utilizing calorie restricted diets that either did, or did not, skip breakfast. In this research both diets caused equal weight loss. In other words, research shows that skipping breakfast has no effect on weight loss results when the diets have equal amounts of calorie restriction.92 The reason this particular study is of interest is because the researchers of this study did note that snacking was increased in the non-breakfast eaters. Eat Stop Eat 72 The authors wrote that, “The other major advantage of eating breakfast was a greater reduction in unplanned, impulsive snacks”. I would argue that since total weight loss was the same, and that skipping breakfast was even associated with better totally body fat loss, this statement could be rewritten to say: “The major advantage of skipping breakfast was a greater ability to partake in unplanned impulsive snacks and still lose significant amounts of weight and body fat.” So the importance of ‘breakfast’ for weight loss seems to be minimal at best, but that doesn’t mean we should all write off breakfast. Just because breakfast isn’t the ‘most important meal of the day’, doesn’t mean it can’t the your ‘most enjoyable meal of the day’. Short-term fasting doesn’t have to mean you ever miss breakfast if you choose to you can arrange your fasts so that you never miss a breakfast. It’s completely up to you. Eat Stop Eat 73 The Health Benefits of Fasting After reviewing all the research I could find on fasting, I was astonished at all the health benefits that short-term fasting can offer. Do you remember in the late 1990’s when the Mediterranean diet became all the rage? The idea behind the diet was based on research conducted in the Greek Island of Crete. The research suggested that the diet of the Mediterranean region was superior to the North American diet. On average, the population of Crete was healthier than North Americans, with less incidence of cardiovascular or heart disease. Researchers attributed this improved level of health to a high daily intake of whole grains, fruits, vegetables and olive oil. This theory made good sense, as these are all accepted ‘healthy’ foods. However, recent reviews by a group of researchers at the University of Crete, School of Medicine suggest that one very important factor was left out of this research. In the Greek Orthodox Christian Church there are some very lengthy fasting traditions.98 The Orthodox Church specifies a combination of dietary restrictions and fasting for a total of between 180 and 200 days out of every year. While this is by no means conclusive evidence, it did suggest that a very healthy group of people were not only consuming plentiful amounts of healthy foods, but also took part in routine periods of fasting.99 Eat Stop Eat 74 By the time I had finished my research, I had come to the conclusion that short term (one to three days) intermittent (never in a row) fasting, was not only an effective and easy way to cut calories and thus lose unwanted body fat, but it was also associated with many amazing health benefits. The science of nutrition is an ever-evolving entity. Every month, hundreds of scientific publications are added to the constantly growing body of literature. This being said, it is a scientific mistake to simply ‘cherry pick’ the latest research. You must have a solid understanding of the entire history of the science before you can accurately analyze it. In fact, the very principles of Eat Stop Eat emerged from three of perhaps the most renowned scientific hypothesis in all of nutrition: 1) The “thrifty genotype” hypothesis of J.V. Neel.100 While the interpretation of this research has changed over the years, and is often misunderstood (at the early stages this theory was even used to support the dreaded “starvation mode”); the theory has now developed into the simple idea that evolution has favored the survival of individuals genetically equipped with a good appetite and the ability to store surplus Calories as fat. The importance of this hypothesis is that it answered the question “Why do we get fat in the first place?” The answer being, “To increase survival by making sure we are able to store energy in the form of fat”. 2) The “glucose fatty acid cycle” by P.J. Randle, et al.101 This hypothesis led to the discovery that free fatty acids from our fat stores and the glucose in our blood literally compete as a fuel source in our bodies, and that our body fat will always win this competition. While this is a very scientifically complex hypothesis, its importance cannot be ignored since it led to the discovery that Eat Stop Eat 75 by burning fat as a fuel (like when you are fasting) you are able to decrease the need for protein breakdown (you won’t burn muscle as a fuel). In other words, the very act of burning body fat preserves muscle mass. 3) The “feast and famine cycle” by Rabinowitz and Zierler.125 This was the first scientific theory that clearly outlined the relationship between insulin and growth hormone, and is the reason why Growth Hormone gets a ‘starring’ role in the explanation of how Eat Stop Eat causes you to lose body fat without losing muscle. The “Feast and Famine cycle” also helps to explain why we burn body fat while we are fasting, and burn Calories from our food when we are eating. These three seemingly unrelated theories were all developed in the mid-nineteen sixties, and all three were considered very controversial at the time. What I found most interesting about these theories was since most people studying nutrition did so under the assumption that we needed to be constantly eating, nobody had really thought to look at these three theories as a whole. In fact, it wasn’t until I looked at these three theories with the idea of fasting that I was able to put them together into one unifying theory that helps explain many of the discoveries currently being made in today’s nutritional sciences. It was these three scientific principles that led to the realization that it made perfect sense that we store energy as body fat. It also led me to realize that it was entirely possible to get rid of this body fat while not losing our muscle mass, and finally, that the special relationship between growth hormone and insulin played an intricate role in this process. It was this revelation that led me to review all the research I could find on the metabolic effects of short-term fasting. By the time I was finished, I had found that in Eat Stop Eat 76 a very impressive volume of published peer reviewed scientific studies, short-term intermittent fasting has been shown to have the following health benefits: • Decreased body fat & body weight • Maintenance of skeletal muscle mass • Decreased blood glucose levels • Decreased insulin levels & increased insulin sensitivity • Increased lipolysis & fat oxidation • Increased Uncoupling Protein 3 mRNA • Increased norepinephrine & epinephrine levels • Increased glucagon levels • Increased growth hormone levels • Decreased food related stress • Decreased chronic systemic Inflammation • Increased cellular cleansing Quite a list, I’m sure you will agree. What is even more amazing is that many of the benefits were found after as little as 24 hours of fasting! From experience in the supplement industry, I can tell you that if you could make a pill with all these claims, you would easily have a 100 million dollar a year product. You’d probably also win a Nobel Prize. These claims are that impressive! Now that we have debunked many of the negative stories about fasting, and have discovered that fasting can have all of these aforementioned beneficial effects, it raises the question – should we all be fasting? In order to find the answer, let’s take a take a closer look at some of these health benefits. Eat Stop Eat 77 Decreased Insulin Levels & Increased Insulin Sensitivity Insulin is one of the most important hormones in your body. Every nutrition, medicine and physiology textbook has at least one chapter devoted entirely to the effects that insulin has on your physiology. Whenever you eat any type of food your blood insulin levels increase. While certain macronutrients raise insulin more than others (protein and carbohydrates having a much larger effect than fat), almost all of the food we eat contains at least two of the macronutrients; thus, it is fairly safe to say that ANYTHING you eat that contains Calories will raise your insulin levels to some degree. This increased amount of circulating insulin drives the storage of nutrients within your body. In other words, insulin is the primary signal that tells your body to store the energy from your food as body fat and glycogen. Insulin is the key that drives glucose (sugar) out of your blood and into your fat and muscle cells. When insulin levels are high, you are in storage mode, plain and simple. What’s more, when insulin is elevated, you are unable to release fat from your fat stores – The key thing to remember is when your insulin is high, your body fat isn’t going anywhere. The problem with insulin lies in the fact that most of us are eating too much too often. As a result we have chronically elevated insulin levels. Chronically elevated insulin levels are associated with the development of insulin resistance, diabetes, inflammation, cardiovascular disease and some forms of cancer. Many popular diets, such as The Zone and The South Beach Diet, are based around the idea of controlling your insulin levels. These diets attempt to help you accomplish Eat Stop Eat 78 this by instructing you to eat small frequent meals that have a lesser effect on your blood sugar levels. While eating frequent small meals, or meals with a low ‘glycemic index’ (a measure of the meal’s effect on blood sugar) may help you ‘control’ or ‘even out’ your insulin levels, this is not always the case. In fact, having very high levels of insulin can actually make something appear to have a low ‘glycemic index’, making someone think their insulin levels are low when in fact they are actually quite high. In fact, it is perfectly possible to overeat and increase your weight and body fat while keeping your insulin levels ‘stable’. This is where fasting is different. Fasting for as little as 24 hours has been shown to drastically reduce your insulin levels.102 This is especially important because in order to burn body fat, insulin levels must be very low. Simply ‘evening them out’ may not be enough, especially if this ‘evening out’ of your blood sugar levels is due to chronically high insulin levels. In research conducted on people who fasted for 72 hours, plasma insulin levels dropped dramatically, reaching a level that was less than half of its initial levels. What is even more impressive is that 70% of this reduction happened during the first 24 hours of fasting.103,104 In other words, a 24-hour fast has a more dramatic effect on reducing insulin than all of the insulin based diets, like low-carb or frequent meal timing, could ever hope to have. If you actually want to bring your insulin levels down, the best tool you have is short term fasting. Eat Stop Eat 79 (As little as 24 hours of fasting can cause a marked decrease in circulating insulin levels.) By fasting once or twice a week you create periods where insulin levels are very low. Combine this with the periods where you are eating and insulin levels are elevated and you recreate the balance of low and high insulin that is needed for the maintenance of good health and a desirable body weight. Eat Stop Eat 80 Decreased Blood Glucose Levels Blood sugar concentration or (blood glucose) is the amount of glucose (sugar) present in your blood at any given moment. Our bodies are remarkable effective at maintaining our blood sugar within a very tight range. Throughout the typical 24-hour cycles of eating, digestion, and fasting, the amount of glucose in your blood is generally maintained within a range of 70-140 mg/dL (3.9-7.8 mmol/L) as long as you are healthy. The problem occurs when we are constantly eating, or even worse, constantly overeating. When we are constantly eating our bodies struggle to keep up with the continuous supply of glucose and we run the risk of chronically elevated blood glucose levels and the long-term health consequences that are associated with this state. This problem becomes even worse in situations of obesity and inflammation. Prolonged excess blood glucose is a key factor that is pro-aging through both direct and indirect effects.105 In clinical research we have seen that giving animals really high blood glucose levels via infusion, (a scientific way of recreating an episode of overfeeding) led to a decrease in antioxidants, increased liver oxidative stress and systemic inflammatory response.106 Luckily, even an extremely short period of fasting (12-18 hours) is enough to allow our body to regulate our blood glucose and return them to their normal fasting level.103 So simply by taking a brief break from eating we are able to give our metabolisms enough time to slowly correct our blood glucose levels and by reducing our body fat, and the amount of food we eat, we create an environment where our bodies can once again easily regulate our blood glucose levels. Eat Stop Eat 81 Increased Lipolysis and Fat Burning There are a few very important steps in the process of burning fat. First, your fat has to be ‘released’ from your adipose tissue (fancy name for body fat). Scientists call this lipolysis, and it involves the process of releasing the fatty acids that make up your fat, and moving these fatty acids into your blood stream so they can eventually be burned as a fuel by your muscles and internal organs. After a series of steps that allow these fatty acids to get to the mitochondria in your muscles (the metabolic ‘engine’ of every cell in your body) these fatty acids go through a process called beta oxidation. This is the final step of fat burning – once this has happened your body fat has now been used for energy. It is gone and it cannot come back. Let’s review that quickly; fat must be released from its storage spot (our body fat), transported through your system, and get to a cellular engine where it will be burned (typically in your muscles or organs). While we are resting, our muscles are a major contributor to our metabolic rate (along with our organs). During a fasted state, our muscles begin to switch over and start oxidizing fatty acids from our body fat as a fuel. In other words, when we fast, our muscles turn into fat burning machines. Despite the common assumption, our bodies DO NOT attack our muscles and use them for fuel when we are fasting. In fact quite the opposite happens – our muscles turn into the machine that actively burns our body fat. A 24-hour period of fasting shifts your body from the fed state to the fasted state, which causes large increases in both lipolysis (fat release) and fat oxidation (fat Eat Stop Eat 82 burning). Simply put, fasting allows your body to take a break from storing fat, and start burning it (which of course, is the EXACT reason we store body fat in the first place!) During short-term fasting free fatty acids start to be released from your body fat as soon as you are done burning the calories that you consumed during your last meal. Depending on the size of the meal, this can happen anywhere from 2-6 hours into a fast. After this point, the amount of free fatty acids entering your blood continue to increase as does the amount of body fat being oxidized for energy. By about the 12-14 hour mark you begin to burn predominantly body fat as your main fuel source. Probably the most revealing information in the research I have read was found in studies published by a group of scientists from the University of Texas, Medical Branch at Galveston. It examined how short-term fasting affects fat and sugar metabolism in our bodies. After only 24 hours of fasting, the amount of fat being released from people’s fat stores (lipolysis) and the amount being burned for fuel (oxidation) had been significantly increased by over 50%. This is a very significant increase in fat burning in a relatively short period of time. This also helps illustrate how even short periods of fasting (approximately 24 hours), can have profound effects on our body’s ability to burn body fat. In fact, recent research has illustrated that fasting actually does a better job than exercising when it comes to turning on some key fat burning hormones. The recently discovered hormone Adipose Triglyceride Lipase (ATGL) is responsible for the very first step of released fat from your fat stores.107 It is ATGL in combination with another enzyme called Hormone Sensitive Lipase that governs the ability of adipose tissue to mobilize fat stores to be used as a fuel. And, it just so happens that Eat Stop Eat 83 short-periods of fasting have an incredibly potent affect on ATGL, even more so than the effects of exercise.108 Short periods of fasting are able to cause a rapid release of FFAs from your fat stores. (Even with short periods of fasting, there is an increased availability of body fat to be burned as fuel) More evidence of the fat burning effects of fasting come from something called Uncoupling Protein-3. Uncoupling Protein-3 is a very important protein found in our muscles that is associated with fat burning. When fat burning increases so does the amount of Uncoupling Protein-3 in our muscles. Amazing research has shown that as little as 15 hours into a fast, the gene expression (amount of protein being built) for Uncoupling Protein-3 increases fivefold!109 Eat Stop Eat 84 This same research also illustrates that the gene expression for Uncoupling Protein-3 continues to increase even up to the 40 hour mark of a fast. (As fat burning increases, so do levels of UCP3) This is very important research because fat burning should be the goal of every diet. You should never lose weight without losing fat. We should forget the idea of ‘losing weight’ and focus on ‘losing body fat’. Eat Stop Eat 85 Increased Glucagon Levels If we consider fed and fasted to be the yin and yang of metabolism, then the hormonal equivalent to fed and fasted could be thought of as the opposing effects of the hormones insulin and glucagon. Insulin is the dominant hormone in the fed state, which causes you to store food Calories in the form of fat and glycogen. Glucagon is one of the dominant hormones in the fasted state that causes fat burning. Quick review: Insulin = Fat storage Glucagon = Fat burning Both hormones are secreted from your pancreas, and while the primary role of insulin is to maintain your blood sugar levels while you are in the fed state, the primary role of glucagon is to maintain your blood sugar levels while you are in the fasted. Insulin maintains your blood sugar levels by telling your body to store extra sugar when your blood sugar levels run the risk of getting too high, while glucagon tells your body to release extra sugar from its stores when your blood sugar runs the risk of getting too low. Glucagon has some amazing effects on the human body beyond maintaining our blood sugar levels, increasing fat burning, decreasing the production of cholesterol, and increasing the release of extra fluids from the body. Because of the typical way we eat, we spend almost all of our time in an ‘insulin dominant’ metabolism (remember insulin = fat storage). By adding fasting into your lifestyle, you allow your body to revert back to a natural balance between an ‘insulin dominant’ metabolism and a ‘glucagon dominant’ metabolism. Eat Stop Eat 86 Increased Epinephrine and Norepinephrine levels Epinephrine and Norepinephrine are fight-or-flight hormones, often called adrenalin and noradrenalin, or collectively, ‘catecholamines’. They are released from the adrenal glands during periods of stress; including times when food is absent (such as fasting) and during intense exercise. When they are released into the blood stream, the catecholamines trigger the release of glucose from energy stores, and increase fat burning. They also make you feel awake and alert. Fasting increases the amounts of both of these hormones in your blood. This is your body’s way of maintaining your blood sugar levels and increasing your fuel supply by helping to release fatty acids from your fat stores. Now, you wouldn’t want your catecholamine levels increased all the time. Like all hormones there is a ‘healthy’ range for your catecholamines and having them extremely low or extremely high for long periods of time is associated with negative aspects of health. However the occasional increases in catecholamine levels you get through both exercise and fasting will help you with your fat loss efforts, and may be partly responsible for the increased levels of concentration and alertness that some people report during both fasting and exercise. Eat Stop Eat 87 Increased Growth Hormone Levels Growth hormone is an extremely important hormone which throughout evolution has had the responsibility of maintaining growth and lean body mass during the times when food is sparse. You’ve probably heard of growth hormone (or GH) since it is getting a lot of press these days. Rumor mills are buzzing that many top-level Hollywood celebrities are taking growth hormone because it helps burn fat, build muscle, and supposedly has ‘anti-aging’ effects. Many supplement companies are scrambling around trying to find anything that will allow them to say their products can increase growth hormone. The ironic thing I learned from all this research is that if you want large increases in the amount of growth hormone released in your body, all you have to do is fast. Research has shown that short-term fasting can result in a sixfold increase in growth hormone levels.25, 110, 111 In fact, fasting can cause very large increases in the amount of circulating growth hormone. The same growth hormone that celebrities, bodybuilders and fitness models pay thousands of dollars for on the black market can be easily had for free, just by fasting! Eat Stop Eat 88 (Fasting increases Growth Hormone) The rumor that taking growth hormone helps in the process of burning fat, building muscle and increasing metabolism is actually supported by research.112,113,114 However, the amazing connection between growth hormone and fasting has nothing to do with injecting growth hormone. It was more than a half-century ago that we first uncovered the powerful role that growth hormone has on fasting metabolism.115 Fasting triggers the “growth hormone response” and this response is what prevents you from losing muscle while you fast.116,117 In fact, research has shown that when people fast and do not have any growth hormone (its release was ‘blocked’ in the study) there is an increase in protein loss by about 50%!118 Yet further evidence that Growth hormone is an incredibly important part of the fasting process. Another point to consider is that growth hormone is the only anabolic hormone that is actually increased by fasting. And, since your muscle is largely responsible for your metabolism, growth hormone also plays a large part in keeping your metabolism elevated while you are fasting.119 Eat Stop Eat 89 Growth hormone also plays an important role in maintaining healthy blood glucose levels while you are fasting. By increasing the amount of fat you’re burning as a fuel, it reduces the need to use glucose as a fuel source. This is important for two reasons: It keeps your blood glucose levels stable, and it is also part of the reason why you do not lose muscle mass while you fast (remember the ‘feast famine cycle’ we talked about earlier). By lowering the amount of glucose that is needed by your body, it prevents your body from breaking down your skeletal muscles in order to make new glucose.120 Not only does growth hormone prevent you from losing muscle while you fast, it is also vitally important in the process of releasing your stored fat so it can be burned for energy, and it upregulates key enzymes that allow for the fat that was released from your fat stores to be brought into your muscle to be burned as a fuel.121,122 It is easy to think of this as a sort of cyclical relationship: Eating prevents the release of growth hormone, while fasting promotes the release of growth hormone. Eating prevents the release and use of body fat as a fuel, while fasting promotes the release and use of body fat as a fuel. Eat Stop Eat 90 Here’s another interesting point about growth hormone: People who are obese have lower levels of growth hormone. This is especially people with a high amount of abdominal fat.123 Not only does being obese tend to lower growth hormone levels, the very act of overeating can cause a rapid suppression of growth hormone. In a study published in 2011 it was found that as little as 3 days of overeating (the people in the study ate about 4,000 Calories per day) was able to suppress growth hormone levels by as much as 80%.124 So being overweight and the very act of overeating (even for a couple days) is able to suppress growth hormone release. Luckily weight loss and the act of fasting is able to improve the release of growth hormone in obese people.131 This growth hormone response to fasting is so important that some researchers have actually argued that in the yin and yang of fed and fasted, it is actually growth hormone and not glucagon that is the dominant hormone in the fasted state because it causes fat burning and preserves your muscle mass.125 FED – Insulin Dominant Metabolism FASTED – Growth Hormone Dominant Metabolism. Eat Stop Eat 91 Growth hormone is also tied to the aging process. Beginning in early adulthood, GH declines at a slow steady rate leading to GH deficiency in some older populations.126,127 These declining levels of GH have been correlated with the weight you gain in older age, as well as reduced insulin sensitivity and even muscle loss.128 So with all these amazing benefits of growth hormone, you may be wondering why everyone just doesn’t inject themselves with GH? As it turns out, research has shown that fasting actually ‘sensitizes’ your body to the fat burning effects of growth hormone. In other words, growth hormone causes more fat loss in the fasted state than if you injected it when you weren’t fasting.114 Another interesting fact about GH is that you need to be fasting, not just dieting, to get its full effect. A 5-day fast (much longer than I would ever recommend) significantly increases spontaneous 24-hour GH secretion, whereas 4 days following a very-low calorie diet does not have the same effect.129 Even more interesting is that adding exercise into your weight loss program seems to increase GH levels more than just a diet alone.130 So the three best ways to get natural increases in Growth Hormone are fasting, exercise and deep sleep – three things that we can all agree are generally associated with good health, lower body fat, and possible even an extended life-span. The key to growth hormone isn’t to have as much as possible, since too much or too little of any hormone in your body can have negative effects. Instead, by fasting you can ‘reset’ the balance between insulin and growth hormone. What’s even better is that as you lose weight, your body becomes better at releasing GH when you are fasting and when you are exercising (talk about win-win situation!).131 It is important to note that while growth hormone does have pronounced fat burning effects in the body, it is by no means a ‘cure all’ or ‘miracle hormone’. It is just one of Eat Stop Eat 92 the many benefits of fasting that all work in connection with each other to help you lose weight. When it comes to building muscle, some people have speculated that the increases in growth hormone caused by fasting can actually help you increase your lean muscle mass. Unfortunately this is typical fitness world conjecture that is not fully supported by research. While this is a very interesting theory and GH has been shown to stimulate protein synthesis and repress protein breakdown, to date there is little evidence to suggest this leads to long term muscle gain.132 In fact, in a recent publication by renowned researcher Michael Rennie it was stated that: “So far, no robust credible study has been able to show clear effects of either medium to long term GH administration, alone or in combination with a variety of training protocols or anabolic steroids, on muscle protein synthesis, mass, or strength.133” The bottom line is most of us spend way too much time in an insulin dominant metabolism, and would benefit from a fast or two a week to help balance our insulin dominant metabolism with our growth hormone dominant metabolism. That being said, as with all hormones, balance is the key. We are not chasing prolonged elevated levels of growth hormone, nor should we have unrealistic expectations of what we can achieve with our fasting. Fasting will help us lose body fat, and growth hormone plays a major role in this process (you really can’t burn body fat without GH), but we cannot expect fasting to have ‘steroid-like’ effects or be some miracle hormone that will cause us to lose fat AND build massive muscles. Eat Stop Eat 93 Increased Weight Loss and Increased Fat Loss As you can see, fasting sets you up perfectly for fat loss and weight loss. Metabolically it prepares your body by increasing all of the hormones necessary to increase fat burning. Added to that, it creates a large energy deficit, so your body has virtually no choice but to start burning body fat for energy. Research shows that you will lose between one and a-half to three pounds every time you fast.8,134 THIS IS NOT ALL FAT. Much of this is extra body water being lost (insulin causes you to store extra water, so when insulin is low, you tend to lose water) and a reduction in the mass of digesting food that is usually in your stomach and intestines. You are also losing fat, but this is a slow and steady process. Depending on your size (taller, bigger people lose more) Most diets see a loss of one to two pounds of fat per week – at best. Adding short term fasting into your lifestyle will have the same effect (just without the daily dieting). (Occasional periods of fasting result in weight loss) Eat Stop Eat 94 People in studies who have used short-term fasting as a weight loss method managed to lose more weight in a 10-week period than people on a very low calorie diet. Even more impressive is that the people who used fasting as a method of weight control maintained most of their weight loss over the course of an entire year. This is very different from the people who were on more traditional low calorie and very low calorie diets, who tended to regain all of the weight one year after their initial diet.135 Another major benefit of fasting is that it can be used to maintain a new lower weight. If fasting twice a week helped you reduce your weight, then fasting once a week may be able to help you maintain that new weight for years on end (as long as you don’t raise your calorie intake or decrease your activity level). Eat Stop Eat 95 Decreased Inflammation If you were to read through the top ten medical journals right now, I would be willing to bet that almost all of them would have at least one article on something called ‘chronic systemic inflammation’. As our understanding of this metabolic process increases we are beginning to realize just how detrimental chronic inflammation can be to our health and well-being. Inflammation is a complicated part of our physiology. Our bodies unleash something called an ‘acute inflammation response’ as a result of injury. With the acute inflammation response the body reacts to a harmful stimulus like a bee sting by inflaming or swelling the area around the harmed tissue in an attempt to remove whatever is harming it (in the case the bee’s stinger). Once this is achieved and the harmful agent is eliminated the inflammation is reduced and the process of tissue repair begins. This response is a protective attempt to remove the painful stimulus and to initiate the healing process. Without inflammation, wounds and infections would never heal. So in this sense it could be said that ‘acute inflammation’ is a good thing that is essential to the proper maintenance of the human body. In fact, this type of inflammation is even involved in the recovery process from exercise. However, chronic systemic inflammation can be damaging to the human body. If acute inflammation is the body’s physiological response to harmful stimuli, then chronic inflammation is the body’s response to the chronic harmful stimuli of overnutrition and excess body fat. In essence, the extra fat and the enlarged hypertrophied fat cells that accompany it are the ‘harmful stimuli’ that is causing the inflammation; only our bodies cannot get rid of the fat with the inflammation response and thus will Eat Stop Eat 96 stay inflamed as long as the extra fat is still present. Now, when it comes to enlarged fat cells causing inflammation, some people seem to be more susceptible than others,136 but the end result is almost always the same – High levels of body fat eventually become associated with chronic low grade inflammation. This type of prolonged whole body (systemic) inflammation is associated with many disease states including: rheumatoid arthritis, hypertension, atherosclerosis, fatty liver, and asthma as well as insulin resistance, cardiovascular disease, diabetes, and even the aging process itself.137,138 For this reason, chronic inflammation is believed to be the link between obesity and many of the life threatening diseases that are associated being overweight. Chronic inflammation has even been linked to many of the causes and risks for the development of cancer.139 Surprisingly, this inflammation-cancer link was suggested as far back as the late 1800’s when German Pathologist Rudolf Virchow stated: “Chronic irritation which is manifested by a chronic inflammation is a key promoter of cancer.” Chronic inflammation is widely observed in obesity and overeating. In fact, excess body fat is the major source of chronic inflammation in the obese (as opposed to some of the other lifestyle factors of obesity).140 Combine this with the fact that both insulin and blood glucose can increase inflammation in a dose-response manner (the higher the chronic levels of insulin, the higher the inflammation) and we can see why obesity or even just periods of overeating can lead to so many life-threatening diseases. In people who are obese we commonly see many elevated markers of inflammation including: interleukin-6, tumor necrosis factor alpha, C-reactive protein, insulin, blood glucose, leptin and interleukin-18.141,142 Luckily, short-term fasting, and more Eat Stop Eat 97 specifically calorie restriction and weight loss, reduces many of these markers of chronic inflammation.143,144,145 Short-term fasting, and the calorie restriction it causes, is able to greatly reduce markers of chronic inflammation through many of the benefits we have already talked about (including the reduction of insulin levels) as well as some we have not (including the manipulation of hormones like adopenectin, ghrelin and leptin). Not only this, but by following Eat Stop Eat lifestyle of flexible intermittent fasting and resistance training (which can also reduce many markers of inflammation146) you get rid of two main causes of inflammation – excess body fat and overeating. And keep in mind, it’s not just the loss of body fat that is having an effect, eating less and exercising also have direct effects on reducing inflammation147, so by doing all three you create a synergistic ‘attack’ on inflammation. Keeping inflammation under control is important for a number of reasons, including overall health, and your ability to build muscle. Even a small increase in chronic inflammation can increase the risk of muscle strength loss and cause a decrease in your ability to build muscle.148 In fact, chronic inflammation has been implicated as part of the cause of the muscle loss that occurs with aging (known as sarcopenia). 149,150 When you consider the fact that chronic inflammation has been suggested to be a major cause of the aging process (this has been called ‘the Molecular Inflammatory theory of aging”) this could make fasting not only your best weapon for weight loss, but also your easiest weapon for combating chronic inflammation and possibly increasing your lifespan. Eat Stop Eat 98 (The anti-inflammatory effects of caloric restriction and weight loss) Eat Stop Eat 99 Increased Cellular ‘Cleansing’ To truly understand the long-term health benefits of fasting, we need to look into a unique process within the human body called ‘autophagy’. Autophagy is a process within your body that is responsible for degrading damaged and defective organelles, cell membranes and proteins. Basically it’s your body’s internal ‘maintenance system’ where it identifies and discards damaged or malfunctioning parts of a cell. The term autophagy was first coined by Christian de Duve over 40 years ago, and is derived from Greek, and means ‘eating of self’.151 In the simplest of terms autophagy is a form of cellular maintenance or cleansing, and it is an extremely important first step in the process of replacing damaged components with newly built components within your. Simply put, it is the clean up that needs to happen before growth and repair can occur. During any given day of our lives there are millions of cellular reactions that occur in our bodies, and overtime, some of these reactions can lead to damage – just like adding miles to a car eventually leads to wear and tear. Only unlike a car, our bodies have their own built in mechanics that can identify and repair this wear and tear, when given the opportunity to do so. Interestingly, the lack of properly functioning autophagy is thought to be one of the main reasons for the accumulation of cellular damage within our bodies and thus accelerated aging within the human body. In other words, the process of autophagy Eat Stop Eat 100 may be an essential part of the anti-aging mechanism, and one of the major health benefits, of fasting. The problem with autophagy is that the act of eating tends to get in its way. It seems that lab animals and human beings left to eat as they please do too little autophagic recycling. The resulting accumulation of damaged cellular machinery can cause a wide range of unhealthy effects, including the accumulation of damaged mitochondria, which increases the production of reactive oxygen species, accelerating further damage and possibly even the aging process by limiting the deposition of aggregateprone proteins and the formation of damaging reactive oxygen species by mitochondria.152 So the more time spend in the fed state, the less time you have to really ramp up the autophagic process within your body. The strong connection between autophagy and fasting is due to the fact that the principle signal to turn up the autophagy dial is the act of entering the fasted state. And if fasting is the signal to turn on autophagy, then eating is the signal to turn it off. Even small amounts of glucose or amino acids are able to inhibit autophagy, as amino acids together with the hormone insulin are its principle negative regulators.153 And it doesn’t take a feast to negatively affect autophagy. Recent research that was published in 2010 found a 3 gram dose of the branched chain amino acid Leucine combined with 7 grams of EAA (10 grams of total amino acids) was enough to decrease autophagy markers in otherwise fasting humans154. So even a small meal in the middle of a fast may be enough to blunt the increased autophagic processes associated with fasting. The upregulation of autophagy seems to be unique to the fasting state, as well as possibly the exercised state, and it can easily be undone by even a small ingestion of food, specifically protein / amino acids. Eat Stop Eat 101 So how important is autophagy to your overall health? Autophagy is of increasing interest as a target for cancer therapy,155 treatment of alcoholic liver disease,156 and as a crucial defense mechanism against malignancy, infection and neurodegenerative disease.157,158,159,160,161 The research on fasting and neuronal diseases such as Huntington’s and Alzheimer’s is also beginning to look very promising as fasting has been found to cause a rapid and profound upregulation of autophagy in the brain,162,163,164 which has the potential to remove toxic molecules and damaged mitochondria from neurons.165, 166,167,168 Research has even found a that autophagy can help the body defend against both bacteria and viruses.169,170,171,172 So the process of autophagy and its importance in cellular maintenance or cleansing is the main reason why some researchers are speculating that intermittent fasting can improve neuronal function and overall health in a way that is unique from any other style of dieting or calorie restriction.173,174 It is also the reason why some people think that intermittent fasting can help regulate the aging process. Since ‘aging’ refers to the biological changes that occur during a lifetime that result in reduced resistance to stress, increased vulnerability to disease, and an increased probability of death, and autophagy can improve many of these areas.175 Finally, it’s not just your health that benefits from autophagy promoted by fasting - optimal autophagic flux is required for the maintenance of the integrity of skeletal fibers, which are the basic contractile units of skeletal muscles.176 Eat Stop Eat 102 Both excess and reduced levels of autophagy are detrimental for muscle health; the former results in the loss of muscle mass, whereas the latter causes skeletal fiber degeneration and weakness.177 So you wouldn’t want autophagy on all the time, but you do need a healthy balance of autophagy and growth for the optimal functioning of the human body. In fact, autophagy is actually necessary to maintain muscle mass, and inhibition/alteration of autophagy can contribute to myofibril degeneration (degeneration of individual muscle fiber) and weakness in muscle disorders characterized by accumulation of abnormal mitochondria and inclusions.178 Since autophagy helps cells break down defective components such as misshapen proteins and dysfunctional mitochondria, it is what ensures that your muscles are full of fully functional proteins, and not simply a conglomeration of damaged or malfunctioning proteins. By allowing for growth when we eat, and the autophagic process of repair maintenance and cleansing when we are fasting, we help restore a balance in the body that may be a missing link in the prevention of many of today’s deadly and debilitating diseases such as cancer, Alzheimer’s and Huntington’s disease, liver disease, and even loss of muscle size and function. Eat Stop Eat 103 Health Benefits – The Conclusion As you can see, fasting has been an often overlooked answer to the health and weight management needs of many people. For the vast majority of us, the answer to the question, “Should we be fasting?” is a resounding YES! For healthy people wanting a simple and effective way to lose weight, the combination of short-term fasting and exercise is an easy way to create a caloric deficit and has no negative impact on our metabolism or our muscle. Not only is fasting an effective way to reduce our calorie intake, it also helps to restore a normal balance between fed and fasted metabolism, as far too many of us are spending every waking moment of our lives in the fed metabolism, under the misled ‘guidance’ of today’s health and nutrition recommendations. This new balance helps reduce our body fat levels, as well as many markers of inflammation and disease risk, and can even upregulate the process of autophagy, potentially protecting from a whole host of diseases later in life, and allowing the body to perform needed maintenance and cleansing at the cellular level. Now, when it comes to many of the other astounding benefits that fasting is reported to have, the evidence is not as concrete, but it is still very promising. Fasting, and even the act of simply eating less has been found to have positive effects on lifespan, disease and aging in research using animals (mostly mice).179 However, recent research conducted by the National Institute on Aging has started to uncover Eat Stop Eat 104 that some of these health and longevity benefits occur in primates like monkeys, leading to speculation that fasting may have some similar benefits in humans.180 What is even more remarkable is that fasting has been shown to decrease many markers of risk of coronary artery disease, leading researchers to speculate that a lifestyle that includes short periods of fasting may decrease the risk of heart disease.181 When you consider all of these benefits including the possible benefits that fasting can have on inflammation, autophagy and the possible risk of Cancer, Diabetes and Cardiovascular disease, it becomes clear that fasting for 24 hours, once or twice a week, may be the easiest way to decrease your calorie intake by 10% to 20%, without having to sacrifice and restrict what you eat during the times when you are not fasting. It’s like getting the benefits of an entire week of strict dieting, while only sacrificing for one or two days. So with fasting we can create prolonged dietary restriction (the only proven nutritional method of weight loss) while only sacrificing one or two 24-hour periods in a week, allowing us to reset the balance between fed and fasted. Using this method allows us to eat less, and reap the health benefits of fasting while still enjoying the foods we eat, since it does not limit the types of foods we eat, or the styles in which we eat them when we are not fasting. The best part of these findings is that since many of the health benefits from fasting occur in the first 24 hours; we can use the Eat Stop Eat style of flexible intermittent fasting and NEVER GO A DAY WITHOUT EATING! Eat Stop Eat 105 The Eat Stop Eat Way of Life It is important to note right away that I do not consider this a diet program. There are no phases, no point systems, no weighing foods, and most importantly no foods that are ever off-limits. I am not going to tell you that sugar is the cause of our obesity problem, because it’s not. Neither is fat. Part of the cause of our obesity problem is that we are failing to realize that we’re looking for the answer in the wrong places. Obesity is not created by one specific macronutrient in our diet. In fact, it’s not the diet at all. In my opinion, the number one cause of our obesity epidemic is abundance. There simply is too much food available for us to consume. As I said earlier, each day in the United States, the food industry produces enough food to supply every single person with almost 4000 Calories (almost double what we typically need in a day).7 Combine this with a highly effective and relentless food marketing industry and a misled and backwards health and nutrition industry and the problem becomes clear: Not only do most of us eat too much, but most of us have no idea why. Eat Stop Eat 106 This is why Eat Stop Eat is not a diet; it is a lifestyle based on the nutritional custom of including the combination of short-term flexible intermittent fasting and resistance training into your life. It’s a way of life where you accept the idea of taking small 24-hour breaks from eating, and taking part in resistance exercises (working out with weights) at least two to three times a week. That’s it. A 24-hour ‘break from eating’ once or twice a week, and a commitment to a workout routine. All my research has led me to the conclusion that this is the single best and most uncomplicated way to lose weight, to maintain muscle, and to reap all the amazing health benefits associated with fasting. Keep in mind, brief breaks from eating are nothing new – almost all of us fast for 8 to 10 hours almost every night, so I’m simply asking you to expand this fast. It is also the easiest way to rid yourself of obsessivecompulsive eating and the need to constantly scour magazines and the Internet for the latest and greatest diet strategy. With Eat Stop Eat, you get rid of the compulsion and guilt that drives so many of today’s eating habits, as we get rid of the idea that you need to be constantly eating, or that there is even one true ‘perfect’ way to eat. The reason I don’t consider this style of eating to be a diet is because unlike almost all popular diets, the Eat Stop Eat lifestyle is a sustainable addition to the way we eat for the rest of our lives. It is the easiest way to lose fat, feel fit, and maintain a lean body, as it does not require any difficult nutritional planning. It does not require special shopping trips, exotic foods or expensive supplements. It simply asks you to refrain from eating for one or two 24-hour periods every week. It is the highly adaptable aspects of Eat Stop Eat that allow people to use follow it successfully to lose weight, and it’s what allows them to keep the weight off for years Eat Stop Eat 107 afterwards. And don’t worry if you can’t fast for 24 hours every time. Twenty-four hours was chosen through my research simply because it was any easy time-frame to remember, allowed people to eat every day, and was suitable for all different levels of body fat and weight loss needs. That being said, there is still a benefit to fasting for 16 hours, just as there is no real harm in fasting for 30 hours. The point is, as long as you are fasting intermittently and resistance training while keeping your lifestyle flexible, you’re doing Eat Stop Eat. In fact, with Eat Stop Eat you are losing fat by doing nothing: not cooking, not eating, and not worrying about what you will eat when you’re eating. In exchange, you spend a little time lifting weights (which you should be doing anyway for the health benefits of exercise itself) and trying to be somewhat responsible on the days that you are eating. Best of all, with Eat Stop Eat style fasting, you never go a day without eating! Eat Stop Eat 108 How to Fast “Eat Stop Eat” Style In order to fast for 24 hours, you can simply eat as you normally would until 6:00 pm on day one, and then fast until 6:00 pm the following day. As an example, you could start your fast on Monday at 6:00 pm and finish your fast on Tuesday at 6:00 pm. People who follow Eat Stop Eat call this a dinner-to-dinner fast. By fasting in this manner you manage to eat every day, however you also manage to take a 24-hour break from eating. More importantly, you break the horrible habit of constantly being in the fed state, thereby resetting your metabolic balance between fed and fasted. You can also adjust this to fit your own personal lifestyle. This is how you can make Eat Stop Eat work for you. If a dinner-to-dinner fast does not work for you, try my personal favorite time frame and go 2:00 p.m. to 2:00 p.m. instead (aptly called the lunch-to-lunch fast). Remember, the Eat Stop Eat lifestyle is designed to be very flexible. The key is to make sure you are asleep during the parts of the fast that you find toughest. As an example, if you find the beginning of a fast harder than the end then you may want to try fasting 8 p.m. to 8 p.m. It is this flexibility that makes Eat Stop Eat so easy. If you were planning on starting your fast on Tuesday, but something came up and you had to go to dinner with Eat Stop Eat 109 friends on Tuesday night, there is no need to worry because you can simply start the fast the next day. Also, keep in mind that as your life changes, so should your fasts. A dinner-to-dinner fast may have be perfect for you when you first start fasting, but after a couple months you may find yourself having a hard time finishing your fasts, or feeling a strong urge to overeat after you fast. The quickest and easiest solution is to try a different fast time. This slight change can have dramatic results on keeping your fasts both easy and effective. Always test new fast times before trying longer fasts. Remember, keeping it flexible is the key to long-term sustained weight loss. Another important aspect of Eat Stop Eat style fasts is that you do drink during your fasts. During your fasts you may drink any calorie-free beverages you like. As an example these are all drinks that would be permissible during your fast: • Black Coffee • Black tea • Green tea • Herbal tea • Water • Sparkling water • Even diet soda pop (if you are the type of person who drinks diet soda) Try your best to keep your calories as close to zero as possible. Once you start adding a ‘little bit’ of cream and sugar to your coffee, or a ‘little sip’ here or there you may find that your calorie intake slowly starts to creep up during your fast. Do your best to try and have a ‘zero tolerance approach’ during your fast. Eat Stop Eat 110 When it comes to what else you can ‘eat’ during your fasts, follow this guideline – the true benefit is learning to take breaks from eating, not to figure out how to ‘game the system’. I often get questions about consuming a ‘little bit’ of beef broth, or coconut water, or xylitol or other ‘almost’ calorie free foods during a fast. There is not enough research for me to answer questions on the metabolic effect of a small amount of calories from all the different food and ingredient sources. So remember that calorie-free beverages are OK during your fasts, and calorie-free gum is all right in moderation, but try to avoid any other ‘almost’ calorie free foods. The key is to learn to take a break from eating, not to continue to reinforce the pattern of always eating and always being fed. So when it comes to what you can and cannot eat while fasting, follow this simple guideline: If you can go without then go without, but if you really can’t go without then don’t. If you are sick, or aren’t feeling well, then you do not have to fast. Eat Stop Eat is a flexible long-term solution. On some weeks you may fast once, others twice. It’s all up to you and your personal preferences. Just do what works for you! To start, try one fast per week. Experiment with what times work best for you. Once you have the hang of fasting then you can increase the amount of times per week that you fast. Avoid the mistakes of trying to fit as many fasts into a week as possible, or trying to extend your fasts far beyond 24 hours. As I mentioned earlier I have found that 24 hours once or twice a week is the most flexible and convenient way to fast. Extending beyond this greatly reduces the flexibility of Eat Stop Eat and may lead to a sort of ‘fasting burnout’. Forcing yourself to fast too often or for too long to the point Eat Stop Eat 111 where you are dreading your next fast completely defeats the purpose of the Eat Stop Eat lifestyle. After talking with literally hundreds of people who have been following Eat Stop Eat, I have noticed that the people who stay flexible and relaxed see the best weight loss results and are able to keep the weight off. On the other hand, the people who try to speed up the process by fasting multiple times per week or extending their fasts to 48 or even 72 hours do see quick results, but also ‘burn out’ very quickly. This is in agreement with the large volume of research on restrained eating, which eloquently shows that the more restrained a person is with their eating, meaning the more rules they try and follow (good food/bad food lists, food combining, etc) the more likely they will see quick weight loss, but also the more likely they will experience extreme weight rebounds after they have ‘broken’ some of their rules and restraints.182,183 Under similar conditions, the more restrained you are with your fasts, the more likely you will feel guilty if you break your rules and end up overeating. The bottom line is that the Eat Stop Eat lifestyle should free you from obsessive compulsive eating, but this should not be at the expense of simply learning to obsess about your fasting. Consider fasting the easiest way possible to get results. Essentially you are getting results from doing nothing, so you do not need to make it any more complicated than an occasional break from eating, but you should go out of your way to view every single complete fast as a ‘mini-victory’ – positive reinforcement at its finest. Eat Stop Eat 112 How to Eat “Eat Stop Eat” Style The point of Eat Stop Eat isn't to force you to not eat; it's actually to give you freedom to eat. That's how balance works. During the times when you are eating, simply maintain the caloric intake that you normally eat while maintaining your bodyweight, while trying to obey what I like to call the “golden guideline of eating”: Eat less, while enjoying the foods you eat. Eat lots of fruits and vegetables, and lots of herbs and spices. And maybe most importantly, spend less time stressing over the types of food you are eating. Pay special attention to that last sentence. All of the posturing and positioning by nutrition experts, and all of the scientists touting their research studies and their socalled conclusions are all based on the assumption that we need to be eating continuously every day. If you start living the Eat Stop Eat lifestyle, all of this becomes a moot point. You can reap the benefits of a low calorie diet, and the benefits of short term fasting, while eating in a way that is sustainable and enjoyable, just by adding in one or two 24- hour fasts into our week. Eat Stop Eat 113 With as little as two fasting periods added into your week, you can create the equivalent of a 20% reduction in Calories. For a person eating 2,500 Calories per day, that’s the equivalent of reducing your calorie intake to 2,000 every day of the week! That’s a 500 Calorie drop, every day. A drop that is the equivalent of removing an entire cheeseburger with a side order of fries from your diet EVERY DAY! The key to making Eat Stop Eat work for you is self-control. This is NOT a ‘fast once or twice a week and eat anything and everything you want every other day’ type of lifestyle. Fasting may have a myriad of health benefits, but it is NOT magic. I think this is a fair trade. While most diet programs ask you to give up certain foods, all I am asking of you is to keep eating the way you normally eat – however, please try to eat sensibly and responsibly. After you have completed your fast, it is important that you go back to eating as you normally would. Pretend that the fast never happened. Remind yourself that you do not need to reward yourself with extra-large helpings or extra desserts. You do not need any special post-fast rituals or supplements. Just resume eating as you would have on any other normal day. The purpose of the fast is to add breaks to your normal eating routine. As soon as you start coming up with special ways to eat and things to do at the end of your fast you’re complicating things and missing the point of the simplicity of Eat Stop Eat. If you want to improve your nutrition while living the Eat Stop Eat lifestyle, go ahead. Nothing but good things will happen if you incorporate a little more fruits and vegetables into your diet and cut back on the sugar, but do whatever is within your own personal comfort zone. I believe the biggest health benefits will come from the fast, but all positive changes will help. Eat Stop Eat 114 If you are following my one simple guideline (from the previous page) you will find that you are already making strides to eating a better diet. I could spend pages telling you about the importance of eating real food over food-likesubstances, but if you are eating lots of fruits and vegetables then you are probably already doing this. I could also tell you about the benefits of avoiding over-flavoring your food with salt and sugar, but if you are eating lots of herbs and spices you are already doing this, too. Finally, I could tell you about avoiding overly processed foods but if you are both eating less and eating more fruits and vegetables, then you are already accomplishing this. While you may find this guideline overly simplistic at first, the truth is there is NO ‘normal’ or ‘perfect’ way to eat for weight loss. This is the great fallacy behind most diet books. The fact is, and always will be, it is calorie restriction that causes weight loss. Any diet book or diet style that claims they have the secret answer or that their way is the ‘only way that works’ is INSTANTLY proven wrong by the millions of people who have successfully lost weight by using alternative methods. For instance, if I were to say that the Eat Stop Eat style of fasting is the ONLY way to lose weight I would INSTANTLY lose all credibility since it is entirely possible to lose weight without following the Eat Stop Eat style of fasting (it just wouldn’t be as easy). Eat Stop Eat 115 The point I am trying to make is that there is NO such thing as an all-encompassing way to define eating ‘normal’. Humans can adapt to a wide variety of feeding regimens depending on the habitual meal pattern, so ‘normal’ is simply what you are used to doing. This is why I don’t ever attempt to define what is ‘normal eating’ or what a ‘normal diet’ is. What is a normal diet to someone who lives in Cairo, Egypt would be very ‘not normal’ to someone who lives in Pittsburgh, USA and the diet of someone who lives in Pittsburgh, USA would not seem normal to someone who lives in Bridgetown, Barbados. Your ancestry, your geography, how you were raised, your personal preferences, as well as your personal goals, define what ‘normal’ is to you. You simply cannot define it in one way for everyone in the world. People eat different types of food in different countries around the world. The way or style in which they eat is also different. Some countries have their meals at very specific times, whereas in other countries people eat at anytime. In Nepal, a typical family does not have breakfast. They have tea around six or seven in the morning, and then they have their lunch from nine to ten in the morning. Supper would be around eight or nine in the evening. In Spain, eating hours are also very different. In Madrid you can eat at any time, though lunch is typically at two in the afternoon and dinner is at nine or ten pm. In Portugal lunch, is typically at around one in the afternoon and dinner is typically at eight in the evening or later. Eat Stop Eat 116 In North America we eat whenever possible. We eat standing up, walking to an appointment, in a meeting, in a hallway, on the subway, in the car, even while lying in bed. We eat wherever it's convenient and even wherever it is not convenient. Even the ‘traditional’ breakfast, lunch, and dinner are only a recent phenomenon that may mean different things to different cultures. Judging from early cookbooks and historical dietary literature breakfast was very rare, and was only recommended for children, invalids and the elderly who have weak digestive systems. The word “Dinner” actually comes from the Latin disjejunare, meaning "to un-fast” or break the fast of the evening. Remarkably, the word was contracted in the Romance languages to ‘disnare’ or ‘disner’ in Old French, or dinner in English. Thus the word dinner actually means ‘breakfast’. Finally, lunch as a meal is a relatively new phenomenon. Dr. Johnson's Dictionary (1755) said Lunch or Luncheon was “As much food as one's hand can hold”.184 By the early nineteenth century, lunch had become a sit-down meal at the dining table in the middle of the day. By the late nineteenth century, luncheon had become a social occasion mainly for elite women.185 Nowadays, lunch has turned into a mid-day feast that can consist of a foot-long sandwich stacked with extra meat and cheese (served in a combo with a large soda and a bag of chips)! Depending on where you live and your family customs, your eating habits could be very different from your neighbors or from what is being recommended in today’s Eat Stop Eat 117 health and fitness magazines. This doesn’t make them wrong, it just makes them different. As you can see there is no such thing as eating normally which makes it impossible to define it. And, pushing yourself to eat in predetermined way with high amount of restrains and forbidden foods can actually worsen your chances of losing weight. This is why I suggest ‘eating responsibly’ over ‘dieting’. Eating responsibly is much easier to define. Simply put, eating responsibly is eating the AMOUNT of food necessary to reach your bodyweight goal, while doing your best to make smart food choices that include a lot of variety. Eating responsibly is also a mindset. It is realizing that on many occasions you are going to want to eat more food than you need to. If your goal is to lose weight, then eating responsibly means recognizing when you are eating too much and either, A) making the decision to stop eating, or B) accepting the fact that at that time you are going to eat more and you will deal with the results later. There is no free pass to weight loss. Or, as science fiction writer Robert Heinlein would say, - there ain't no such thing as a free lunch. And, despite what some people say, you simply cannot eat as much as you want and still lose weight as long as you take supplement X or follow diet Y or exercise routine Z. Even getting the fat cut right off your body in a surgical procedure still does not constitute permanent weight loss. (Yes, you can eat enough food to put that weight right back on! The remaining fat cells can still expand and fill up with fat if you continue to wolf back massive amounts of Calories after the surgery) Eat Stop Eat 118 The bottom line is that it is the last part of my guideline that could very well be the most important part: Eat less, while enjoying the foods you eat. Eat lots of fruits and vegetables, and lots of herbs and spices. And maybe most importantly, spend less time stressing over the types of food you are eating. This is the very important (and VERY underrated) goal of having a good healthy relationship with the foods you eat. I know this sounds very 'new age' but I assure you that a lot of today's overeating and obsessive compulsive eating habits come from unhealthy relationships with food, where people feel stressed and guilty every single time they eat. If you are enjoying the foods you eat, and not stressing about your food choices, then you are doing an amazing job avoiding this problem. So with the Eat Stop Eat lifestyle, (where rational simplicity is always the goal), this one simple guideline is all you need to guide your eating habits. However, if you would like to try and improve how you eat for the purpose of overall health, there are steps you can take. When it comes to health, I simply do not agree with the common suggestion that the secret to eating for health is avoidance, yet this is where 99.99% of all of our nutrition recommendations come from. For example, you may have read some or all of the following items to avoid: “At all costs, avoid caffeine, sugar, white potatoes, saturated fat, trans fats, artificial sweeteners, artificial colors, artificial flavors, bread, gluten, legumes, dairy, anything cooked and non-organic foods.” Eat Stop Eat 119 I’m sure you’ve read this type of nutrition advice before. In my opinion, this is a form of scaremongering. In fact, I’d go so far as to say it is dietary extremism masquerading as healthy eating, and it can actually damage your chances of losing weight. Attempting to adhere to a very strict diets with large lists of foods you are not allowed to eat typically ends up in failure, due to something called the ‘disinhibition effect’ – a paradox where merely labeling certain types of food as ‘off limits’ or ‘forbidden’ creates a disinhibition; where eating the foods you consider forbidden leads to increased eating afterwards.186 This disinhibition is not a result of the specific type of food, or its calorie content187 or even its macronutrient profile.188 Rather, it comes from the self-created belief that certain foods are forbidden, and the feeling of failure you get after eating them. Indeed, the very act of eating even a small amount of a ‘forbidden’ food can cause a person enough stress and anxiety that they actually overeat even more afterwards. This is the opposite of what happens to a flexible dieter, who while still reducing overall calories does not follow an all-or-none approach to restraining the types of foods they can eat. Flexible dieters do not suffer from disinhibition effect, and if they eat a small amount of dessert they do not feel the need to overindulge afterwards, probably because they do not feel like they ‘blew it’.189 So following these ‘good food, bad food’ type of diets can actually worsen your chances of maintaining long-term weight loss. If I had to pick one word to describe healthy eating it would be ‘Variety’. As much variety as you can fit into your life. There are hundreds, if not thousands of undiscovered chemicals in the foods we eat. From strawberries to steak, we have only a small understanding of the complexities of our foods. Many of these chemicals are Eat Stop Eat 120 inert (meaning neither good nor bad for us), however some will be good, and some may be bad. The way to balance all of this is with variety, by picking as many foods as possible. By striving to eat with variety we avoid over-eating or under-eating any one nutrient, discovered or yet to be discovered. As an example, you do not need to avoid simple sugars in your diet. If you increase the variety of foods you eat, it becomes very difficult to over-eat any one type of food – Whether it be sugar, fat, protein, salt, or anything else you’d care to name. Even foods we have been led to believe are extremely healthy fail in comparison to variety. A breakfast of raw cashews, organic yogurt, and coconut flakes followed by a cup of matcha green tea may sound extremely healthy, but without variety it becomes extremely limited. In fact, a person who eats this type of breakfast every day for months on end would probably benefit greatly from the occasional breakfast of eggs and bacon, or oatmeal and blueberries...just something DIFFERENT. There is one problem with the concept of ‘variety’ and that is that research has shown us that eating for variety tends to lead us to eating more.47 Eat Stop Eat 121 This is where self-control comes in. Just like the balance between fed/fasted and insulin/growth hormone, you also need to find a balance between eating for variety while still eating less so that you can lose weight. This is another benefit of Eat Stop Eat. It allows you to eat less, without imposing any rules or restrictions that may limit your ability to eat for variety. Living the Eat Stop Eat lifestyle is the simplest way to improve your health, without massively restricting the foods you are allowed to eat. This gives you your best chance to eat a wide variety of foods while still eating less, thus ensuring what I would consider to be an optimal approach to health and weight loss. Here’s another amazing benefit of the Eat Stop Eat lifestyle; research has shown that even if you were to gorge yourself on your eating days (which I do not recommend) to the point where you don’t lose any weight at all, you will still see some of the health benefits associated with fasting, such as improved insulin sensitivity and decreased oxidant stress.190 Eating with variety, and eating less without practicing restrained eating is a large part of the Eat Stop Eat lifestyle. Combined with the small ‘wins’ you get every time you complete a 24 hour fast and you create a flexible and positive approach to eating and weight loss. Eat Stop Eat 122 What to do while Fasting Since I do not consider the Eat Stop Eat lifestyle to be a diet, it would be a waste for me to fill two hundred pages of this book with recipes, food combining instructions or calorie and protein charts (go browse through any other diet book and you’ll quickly discover that most of the pages are just that). Doing so would not help you in any extra capacity. In fact, it would do quite the opposite. It would clutter your mind with needless rules to obsess and stress over, and possibly setting you up for disinhibition effect while not moving you any closer to your weight loss goals. Instead, the best thing I can do is provide you some tips to help make your fasts a little easier. The first and most important thing you need to remember is to drink a lot of calorie free fluids; this will help you avoid getting thirsty, which is often mistaken as hunger. In the morning start your day with a large glass of water. Black coffee and tea are also allowed during a fast. You may also find diet colas useful, and don’t worry about having a small amount of artificial sweeteners during your fast, in my opinion the health benefits of fasting far outweigh any worry about the small and infrequent intake of artificial sweeteners. Eat Stop Eat 123 Also, the current buzz about aspartame causing giant insulin spikes is not founded in science. There have been multiple studies on aspartame and its effect on insulin and growth hormone and they have all found no negative effects on either hormone.191,192 My personal opinion is that you’re not missing out on anything by avoiding aspartame, so when possible and within reason, make non-artificially-sweetened choices (especially when you are not fasting); however, I do not see them as being detrimental to your fasting. The other common misconception about coffee, teas and colas is that caffeine causes giant increases in insulin. While it is true that caffeine can cause an increased insulin response to large doses of carbohydrates (caffeine + carbs = more insulin release than carbs alone).193,194 I have never seen any research suggesting that caffeine alone, without any carbs, causes insulin release. From a metabolic point of view, these drinks should not interfere with your fasts. You may also find it helpful to stay busy while fasting. Recently I had someone tell me that, “fasting is easiest when I’m busy. I think if people’s lives were a little more exciting they wouldn’t need to eat so much to get some joy out of their day.” This statement is very true. Food is a form of ‘bio-feedback’. It is a form of stimulus in our everyday lives. So when parts of our days are lacking excitement or stimulation (like when we are sitting in a car stuck in rush hour traffic), we seek stimulation in the form of foods and snacks. Have you ever had a really boring day at work? Did you ever notice how often you snacked, or made coffee? This is because you are replacing mental stimulation with food stimulation. Eat Stop Eat 124 A little complex, but it is the short answer to why we should stay busy while fasting. Other than staying busy, you can go about your day as if it were any other day. You can go to work, go shopping, go work out. Whatever it is you normally do during your day. This is the beauty of the Eat Stop Eat lifestyle. It is the simplest way to lose fat and improve your health and well-being, without drastically changing the way you live. In fact, you will probably find that you have a lot of spare time on your fasting day. Almost everyone who lives the Eat Stop Eat lifestyle experiences this new freedom and extra time. At this moment you will also realize how much of your daily routine is spent planning, preparing, going out for, and eating food. Taking a break from eating might just be the only way to actually free up useful time in your week. Lastly, view every single fast you complete as a small ‘win’ towards your weight loss goals. This is a unique feature that sets fasting apart from traditional dieting. By viewing each fast as a small win, you create a positive reinforcement as you move towards your weight loss goals. By ‘conquering’ a fast you teach yourself that weight loss is possible, and that YOU are in control. The main problem with traditional diets is that they seem like a long slow march towards an inevitable failure. Going weeks and weeks without messing up or ‘cheating’ only to hit that one day where you ‘break’ and eat a donut only teaches you that you will inevitably fail at dieting. This is negative reinforcement and it can destroy your future weight loss goals. Stay positive and flexible with fasting. Every single 24-hour fast you complete is small win towards hitting your weight loss goals. Eat Stop Eat 125 How to work out with Eat Stop Eat Resistance training is an essential part of the Eat Stop Eat lifestyle. The combination of fasting and responsible eating will allow you to lose body fat quickly and easily, but it is your resistance-training workouts that will ensure you maintain (or even increase) the size of your muscles while you are losing body fat. I think just about everyone will agree that working out with weights (or any other form of resistance) will result in increased muscle mass, given that the weight used is high enough and rest and recovery periods are adequate. It was more than 30 years ago that a group of scientists proved that the amount you use your muscles is the main factor in influencing how big they are (other than genetics and height). In other words, how much and how often you stress your muscles dictates how big your muscles will become.195 Weight training while following the Eat Stop Eat lifestyle will work your muscles in a way that promotes growth and preserves muscle mass while you are losing body fat. There are many other reasons that people follow resistance training programs, such as to improve their skills at a sport (sport-specific training), to increase their strength Eat Stop Eat 126 (power lifting or Olympic lifting), the prevention of osteoporosis (loss of bone mass) or even as a form of rehabilitation from an injury. All of these purposes represent effective uses of weight training, but for the purpose of Eat Stop Eat, we will concentrate on the use of weight training for the purpose of preserving muscle mass (and metabolic rate) while following a reduced calorie diet. Of course, in doing so we reap all the other health benefits of resistance training, including improved cholesterol levels, improved blood sugar control, increased bone density and the often underappreciated value of exercises ability to elevate mood, and improve body image (an invaluable part of any weight loss program)196,197. There are many different types of resistance training workouts that complement the Eat Stop Eat lifestyle, and it is important to note that I am not an exercise physiologist. Even though I have spent over seven years working in the bodybuilding industry, and have obtained certification as a strength and conditioning specialist from the National Strength and Conditioning Association, I do not consider myself an expert in this field. So while I am not an expert in workout design, I can share with you the principles of resistance training that have been tested in scientific studies. If you are looking for a specific workout plan or blueprint, I highly recommend you seek the advice of an exercise physiologist (with at least a graduate level education) for a detailed and progressive workout program that fits your own personal goals and needs. I often like to think of the legend of Milo of Croton when determining what will – and what will not – work as an effective workout program. Milo (sometimes referred to as Milos) was a six-time Olympic champion wrestler in the sixth century BC who used a rather unique training style to build his physique. Legend has it that Milo would lift a baby cow over his head every day until it became a full-grown cow. And, while this legend changes from Milo simply lifting the cow to Milo doing laps around the Pantheon while carrying the cow, the simple point is that this must have been an Eat Stop Eat 127 impressive feat of strength considering a full-grown cow can weigh as much as 1,000 pounds! We can learn two important lessons from the legend of Milo. First, your workouts need to be progressive if you want to gain or even keep your muscle mass. In other words, as you grow stronger you must continue to increase the amount of work you do with your muscles. In Milo’s case, this was conveniently taken care of for him as the baby calf he began lifting slowly grew in size and weight with each passing day. The load that he lifted increased every single day – this is a perfect example of progressive overload. You probably won’t be lifting a baby cow as part of your workout routine, so in a more practical example you have three realistic ways that you can increase the amount of work your muscles do in a workout: • Use more weight for a given exercise (intensity or stress) • Lift the same weight more times (volume) • Lift the same amount of weight more often throughout the week/month (frequency) Typically, most weight training workouts that have been used in scientific studies use a combination of these three principles to ensure the workouts are progressive in nature. Here is a simple example using the bicep curl exercise. Our baseline workout for bicep curls will be 1 set x 20 pounds x 10 repetitions once per week. In this example the total work for this exercise is 1 set of exercises using 20 pounds x 10 reps = 200 pounds of total work per week. Eat Stop Eat 128 Let’s look at three examples of how to change this total work, using intensity, volume, and frequency over the course of one week. Intensity (or stress) You can increase the total work number from our example above by simply adding 5 pounds per repetition. The new equation would be 25 pounds x 10 reps done once per week = 250 pounds of total work per week. Volume You can also increase the total work number by adding more reps per set. If we add 5 repetitions per set the new equation would be 20 pounds x 15 reps done once per week = 300 pounds total work per week. Similarly you can keep the reps the same but add an extra set. The equation would now be 20 pounds x 10 reps x 2 sets = 400 pounds total work per week. Frequency Finally you can increase the total work by adding more workouts per week. If you simply did our example workout twice in the same week the new total work equation would look like this: 20 pounds x 10 reps x 2 workouts = 400 pounds total work per week By using any combination of increasing intensity, volume or frequency you can ensure that your workouts remain progressive. Eat Stop Eat 129 The second (and probably most important) lesson to be learned from Milo of Croton is that the exact details of what equipment and program you use and how you use them probably does not matter too much as long as you are sufficiently stressing your muscles. The ‘resistance’ can come from your body weight, free weights such as dumbbells, elasticized bands, machines, or even lengths of chain! If there is any secret to weight training it is simply that consistency and effort are what will get you the best results, and while there are many different ways you can perform a weight training workout, science has not yet identified the ‘best’ way to work out and probably never will. However, scientific research can provide us with a rough but effective outline that we can use to determine the effectiveness of a workout program. According to the scientific review entitled “The Influence of Frequency, Intensity, Volume and Mode of Strength Training on Whole Muscle Cross-Sectional Area in Humans” muscles will increase in size when they are exercised within a range of two to four times per week, allowing enough time between workouts for proper recovery.198 The amount of recovery time needed depends on your current training status and the stress of your previous workout. In other words, how accustomed you are to the workout and level of difficulty of the workout. An optimal workout schedule should allow each major muscle group to be exercised roughly twice per week, which scientific research suggests is a sufficient amount for causing muscle growth and the preservation of muscle while you are dieting. Exercise sessions should consist of between three and eight sets per muscle group (depending on the size of the muscle), with optimal results occurring when each major muscle group goes through 40-60 repetitions per workout. Examples of this style of workout would include any combination of sets and repetitions that allow a muscle to fatigue at between the 6th and 15th repetition. Eat Stop Eat 130 There are many different ways a workout can be designed to meet these recommendations. Examples include three sets of 15 reps, four sets of 10 reps, eight sets of eight reps or even 10 sets of six reps. Hopefully, you can see that outside of these basic recommendations there are many different ways you can design a workout to meet your requirements, and I encourage you to try many different styles. Truthfully, the general beliefs in this area are as muddled and confusing as they are in the field of nutrition. As an example, research has suggested that using a light weight for a high amount of reps (between 20-25) may be as efficient at building muscle as using heavy weights for low reps (between 1-5) as long as the total amount of work complete is equal.199 While obviously we still have a lot to learn when it comes to all of the mechanisms behind muscle growth, these guidelines are a good representation of what has been found to be effective in well-controlled clinical research. The important thing to remember is that exercise serves a number of benefits. Besides simply building muscle, the effect of exercise on mood, self-esteem, and body image cannot be stressed enough. After all, what good is losing weight if you still don’t feel good about yourself? Eat Stop Eat 131 Designing your own workout program In most research trials where people on a low calorie diet preserved lean mass by using resistance training, their workouts fit into the following parameters: They typically worked out three to four times per week with each workout session lasting about 45 minutes. On average, two to three muscle groups would be exercised per workout session. Each workout consisted of between six to 10 exercises with each exercise being completed for two to four sets of eight to 12 reps. Rest periods would consist of up to two minutes rest between each set of an exercise. As I mentioned earlier, it is important to choose the workout style that fits your own individual goals and needs. This is the main reason why I cannot ‘prescribe’ a workout for everyone who follows the Eat Stop Eat lifestyle. As an example, it takes a high amount of weight, volume, and stress for a 250-pound bodybuilder to maintain a high level of muscle mass. If a 250-pound bodybuilder were to follow Eat Stop Eat, the amount and type of exercise that he would need to do to maintain his muscle mass would be much greater than what a 145-pound woman who hasn’t previously exercised would need to do. Further, a 145-pound woman who hasn’t previously exercised in this manner would see very little benefit from immediately following the bodybuilder’s workout routine. Selecting the appropriate exercise program depends on the following factors: Eat Stop Eat 132 • Your current training status (how much you currently work out) • Your goals (maintain or gain muscle) • The amount of muscle mass you are currently carrying An easy rule of thumb would be to look at the amount of exercise you were doing before you started following Eat Stop Eat, and make sure to slowly progress from there. Just like your nutrition program, your workout routine should revolve around the simplest and easiest methods that get you the results you want. The importance of sticking with it If you are fairly inactive, then starting a workout program may actually be very difficult. Research has suggested that as many as 50% of people who start a new exercise program will drop out within six months.200 Most of the time people say the reason that they stop exercising is that they are tired or because of lack of time. It is very important that you stick with your program, short of becoming obsessive about exercise. Not only will sticking to your workout program help you preserve muscle mass while you are losing body fat, but it will also keep your mood elevated. In some very interesting research published in 2008, it was found that when a group of women who exercised regularly were forced to stop exercising for 72 hours, there was a noticeable decrease in their body satisfaction and mood. The results of this study also showed that after 72 hours of non-exercise, feelings of tension, anxiety and sluggishness were increased.201 Of course, this is ironic considering that these are the exact reasons why most people stop working out in the first place. This leads to the idea of a downward spiral when you quit an exercise routine. You quit because you are tired or stressed, only to become even more tired and even more Eat Stop Eat 133 stressed, and then the spiral picks up momentum, and you end up glued to your couch unable to even think about the stress of re-starting another exercise program. When it comes to exercise, balance seems to be the key. Too much exercise and you increase the risk of overuse injuries and you could become obsessive, defining yourself as a person by your exercise program. Too little exercise and you lose the muscle maintaining and myriad of health benefits. Not only this, but you also run the risk of becoming dissatisfied with your body, as well as experience a decreased mood. For Eat Stop Eat the goal is to use exercise as a tool: Doing the amount needed to preserve or build some muscle, but not becoming obsessive to the point where exercise interferes with your life. You should look forward to your next workout session, not dread it. And never let it define who you are as a person. For this reason I recommend keeping your exercise plans as uncomplicated as possible, following the suggestion in the above paragraphs. A note on “Cardio” training for weight loss The goal of the Eat Stop Eat lifestyle is to let your diet lead to a decrease in body fat, while using resistance training to maintain or increase the size of your lean body mass. While traditional cardio training will not ‘sabotage’ your fat loss results from following Eat Stop Eat, you may be surprised to see that it doesn’t typically produce as large of a fat burning benefit as you might have been led to believe. This doesn’t mean that cardio is bad for you or a waste of time. Cardio training may indeed benefit your overall health, it just might not pack as much of a fat burning punch as some people wish it would. Currently the recommendation for adults is to engage in at least 150 minutes of moderate-intensity physical activity per week.202 This seems like a reasonable Eat Stop Eat 134 suggestion. However, I have found from both personal experience and from reviewing clinical research that the work-to-reward benefit of cardio for the purpose of burning more fat is relatively low. THIS DOES NOT MEAN THAT CARDIO DOESN’T ‘WORK’. Rather, it means you have to do a disproportionately large amount of work in the gym to receive noticeable fat-burning results. In other words, it may help with fat burning, but you better be prepared to spend a large amount time to get this benefit. Believe it or not, most research trials examining the weight loss caused by very-lowcalorie diets found that adding exercise did little to increase weight loss beyond what the diet alone could achieve. The diets seemed to do all the work. Take, for instance, the research conducted by Donnelly et al. that was published in 1991. Sixty-nine obese women were put on an extreme 520-calorie per day diet (this is much lower than I would EVER recommend). The women were then divided into 4 groups: Group 1 did not exercise. Group 2 did endurance exercise for 60 minutes four days per week. Group 3 did strength training four days per week. Group 4 did strength training AND endurance exercises four days per week. At the end of the 90 days research trial all four groups lost a large amount of bodyweight, averaging over 40 pounds of weight loss! The interesting finding was that there were no differences between the four groups in terms of the amount of weight or body fat that was lost. This is despite the massive amounts of exercising that the women in Group 4 were doing compared to Group 1! This conclusion has been found over and over again in published research. Donnelly and co-workers did a second trial that was published in 1993 demonstrating that weight training could increase muscle size while women followed an 800-calorie per day diet, but it could not improve weight loss or fat loss. Similar results have been Eat Stop Eat 135 found by research conducted by Kraemer in 1997, Bryner in 1999, Janssen in 2002, and Wang in 2008, just to name a few examples. As you can see, exercising for weight loss has been studied quite extensively and repeatedly proven to be less effective than we have been led to believe. Uncovering the reason why exercising for weight loss performs so poorly in clinical trials has proven to be very difficult. We know that extra exercise does create a larger calorie deficit (since exercise burns calories) However, this extra deficit does not seem to show up on the weight loss side of the ledger, therefore either the deficit isn’t as large as we thought, or there is compensation occurring somewhere else in our lives. The most obvious answer is that exercise simply causes people to eat more later in the day. The saying “work up a good appetite” seems to support this idea. However, clinical research suggests that this is not the case. A review published in 2003 suggests that men and women can tolerate exerciseinduced acute energy deficits and do not compensate by eating more later in the day.203 Other studies have found that this holds true for both lean204 and obese205 people. In fact, another line of research even suggests that exercise may even help control urges to binge and eat in response to negative emotions206, and overall seem to have a better control of their appetite.207 So while it may be true for some people, research suggests that for many people, exercise does not ‘cause’ you to eat more calories. The other suggestion is that exercise can create a decreased amount of movement in the period after the exercise. In research we call this ‘spontaneous physical activity’. Eat Stop Eat 136 To give you a very crude idea of the theory it would look something like this: On the days that you exercised you also spent slightly more time sitting on the couch, maybe climbed the stairs of your house a couple times less, and then took fewer overall steps. These little decreases in spontaneous physical activity may diminish some of the benefit of the exercise. This has also proven to be very difficult to measure in a research setting. The true answer is probably a combination of all of these theories: The calorie burn from exercise is simply less than we expect (or want to believe) and small changes in both post-exercise spontaneous physical activity and even smaller increases in calorie intake all come into play in making exercise less effective than we would like. Regardless of the illusive cause, the fact remains that exercise seems to be less effective than we would like to think. However, as I stated before, this doesn’t mean exercise is useless for weight loss. A single bout of exercise stimulates adipose tissue blood flow and fat mobilization, resulting in delivery of fatty acids to skeletal muscles at a rate well-matched to metabolic requirements. With chronic exercise (training), there are changes in adipose tissue physiology, particularly an enhanced fat mobilization during acute exercise. Epidemiological observations support the idea that physically active people have relatively low fat mass.208 Exercise also seems to be able to cause preferential weight loss in the visceral fat deposits, more so than either resistance exercise or simply calorie restriction.209,210 So for people who store a large amount of fat viscerally, exercise may be a valuable addition to their weight loss program. Perhaps exercise is not causing MORE fat loss, but rather a slightly more desirable distribution of fat loss. Eat Stop Eat 137 The truth is that if you get your diet in order and are following a nutrition program that allows you to decrease your caloric intake, it will cause you to lose weight. Adding 'calorie burning exercises' does not seem to increase this weight loss to as large a degree as we would like, but may create small improvements in both weight loss and health. Adding strength training is still the number one priority for anyone attempting to lose body fat since it can preserve or even help increase the size of your muscles while you are dieting, and prevent undesirable changes in your metabolism. However, for those people who have the time or specific need, adding extra cardio can still be an added fat loss benefit…if you have the time. The bottom line when it comes to Eat Stop Eat and the Eat Stop Eat lifestyle is the following: The simple approach is the one that works best, and this approach involves eating for fat loss and working out to preserve (or even increase) the size of your muscles. Add cardio only if needed, only if you find it enjoyable, and have the available time. Eat Stop Eat 138 The Health Benefits of Exercise It should be obvious that maintenance of lean body mass isn’t the only benefit of following a well-planned exercise program. In fact, I would argue that there are other benefits that are much more important to our overall health. Similar to fasting and simply eating less, following a resistance training program can decrease many markers of chronic inflammation, such as IL-6, resistin and leptin.211 Since chronic inflammation is a risk factor in many diseases, it’s no wonder why regular exercise is recommended as an anti-inflammatory therapy.212 The effect that exercise has on inflammatory markers does seem dependent on the intensity of exercise, training status, age, and severity of existing health conditions, but for the most part almost any form of exercise will have some form of benefit.213 When you combine the anti-inflammatory effects of exercise with the already mentioned benefits of improved cholesterol levels, improved blood sugar control, increased bone density, and the ability of exercise to elevate mood and self-esteem, it becomes clear that there is more to exercise then simply building muscle.214,215 However, the fact that proper functioning muscle may play a role in all of these factors of health cannot be denied. Just remember exercise is a tool: Do the amount needed to preserve or build some muscle, but try your best to avoid becoming obsessive to the point where an addiction to exercise interferes with your life. Eat Stop Eat 139 How to “Keep it Off” with Eat Stop Eat Obviously the goal of any weight loss program should not be quick short-lived weight loss. To truly reap the benefits of any weight loss program the results need to be long lasting. Let’s face it; nobody wants to put the effort into losing weight just so they can gain it back. Typically, maximal weight loss occurs during the first 6 months of a diet, after which, weight regain slowly begins to set in.216 Luckily this could be one of the greatest strengths of Eat Stop Eat. Let me explain: Most research looking at long term weight loss follow a protocol like this: Get a bunch of people and make them lose weight very quickly using a very-low-calorie diet with lots of clinical supervision, rules, support groups, follow up meetings, guidelines and checklists. Typically, once the subjects have lost roughly 10% to 15% of their original bodyweight they go on to the weight maintenance period of the study where researchers test different ways of eating to see if some are better than others at helping people maintain or even improve upon their weight loss. The studies have been remarkably conclusive in that the specific macronutrient profile of the diet did not matter. In other words, the amount of protein, carbohydrates and fats in the diet does not affect how well the diet is able help you keep the weight off. Although some randomized trials have indicated that carbohydrate-restricted diets are advantageous compared with higher-carbohydrate diets in achieving weight loss over 6 months, longer trials have shown that the advantage is not sustained beyond this Eat Stop Eat 140 time frame. Which is another way of saying that after one year, there is no significant difference in how much weight these people kept off, regardless of how high or low their carb or protein intake was.217,218,219,220 There may be some benefit to eating slightly more protein and slightly fewer carbs in some people, but clearly it takes more than simple changes in the macronutrient composition to maintain weight loss, and a change in lifestyle must occur at the same time as a strong commitment to eating less. In fact, research has found two things: 1. Your ability to keep the weight off is directly related to your ability to maintain a flexible amount of dietary restraint.221 2. Your ability to keep the weight off is directly related to how well you maintained your lean body mass while you were losing weight.221 Now, after reading point two you may immediately be thinking of some scientific explanation that includes the ‘metabolism’ boosting effect of lean mass. There is another just as plausible explanation to why preserving your lean body mass helps people lose weight: People will be rewarded psychologically and socially from the changes they’ve made in their body and be more willing to maintain dietary restraint in order keep this new body shape! In other words, having less fat and a defined lean body makes you look good, and it only takes a few compliments on your new lean toned body to keep you highly motivated to keep it up. Regardless of why maintaining your lean body mass improves your ability to keep the weight off, the point remains: If you can follow a method of eating that allows you to eat less for long periods of time while still eating the foods you enjoy, and if you can Eat Stop Eat 141 preserve your lean body mass while you lose body fat, you greatly increase your chances of keeping the weight off! This is the major benefit of Eat Stop Eat. You still eat the foods you like without restricting yourself to lists of good foods and avoiding everything on a list of bad foods. You still have to eat less, but you are in charge of the foods you choose to eat. By being flexible and not restrictive it allows you to enact a great deal of dietary restraint without feeling deprived or bored of your food choices. And a very large body of research suggests that this flexibility is a key to long-term weight loss success. There are a large amount of epidemiological222,223,224,225 and intervention studies226,227 that clearly point to the relative advantage of flexible restraint of calorie intake over rigid control for long term weight loss success. Combine this with the research showing that people who used fasting as a method of weight control maintained most of their weight loss over the course of an entire year,228 and you can see why the Eat Stop Eat lifestyle can be incredibly effective at not only helping you remove the excess weight, but keeping it off for good. Eat Stop Eat 142 Eat Stop Eat Conclusions By now I hope it is apparent to you that short periods of intermittent fasting combined with a regular resistance-training program is an easy, uncomplicated, and highly effective way to lose weight. It can also help correct some of the negative metabolic effects that come from spending so much time in the fed state, and can improve many markers of long-term health. While many diets tout day-by-day diet plans, cookbooks and charts of acceptable and unacceptable foods, none of this is needed when you adopt the Eat Stop Eat lifestyle. Eat Stop Eat will hopefully free you from the nutrition info-clutter that surrounds us every day in the media. My opinion is that there is ZERO relationship between how many fitness marketing emails we receive each day, how many fitness books we read, how many health forums we visit, and how much weight we lose or how healthy we feel. Stressing over what we eat, how we workout, what to do to lose weight and all the confusion and frustration that goes along with these things no longer needs to be a part of your life. You do not need any of them to lose weight. Any message that is full Eat Stop Eat 143 of nutrition and fitness rhetoric and ‘eat this, not that’ lists and rules that ‘you absolutely need to follow’, is nothing more than nutritional mind-clutter. More importantly, getting rid of this stress can actually improve your weight loss and overall health. A surprising as it sounds, ‘stressing’ over your diet can actually make losing weight more difficult. It has been suggested that excessive psychological stress combined with overeating can actually have synergistic effects that are damaging to both your weight loss goals and long-term health.229 What is interesting is that the stress of excessive dietary restraint, especially when not accompanied by the act of actually eating less can increase markers of stress response within the body.230 So when I say that ‘stressing’ about eating healthy isn’t good for you, I mean it in the most literal sense! Now there is still a benefit to healthy eating. I still recommend eating a variety of fruits and vegetables combined with some sources of protein, but I emphasize that in the Eat Stop Eat lifestyle, you do not have to stress over what you choose to eat. In fact, the Eat Stop Eat lifestyle can be best described by slightly altering a famous Zen quote: “Before you study Zen, mountains are mountains and rivers are rivers; while you are studying Zen, mountains are no longer mountains and rivers are no longer rivers; but once you have had enlightenment, mountains are once again mountains and rivers again rivers.” With a couple of small changes, we can sum up the Eat Stop Eat view of food and nutrition with one (rather long) sentence. Eat Stop Eat 144 “Before you study Nutrition, food is food and drink is drink; while you are studying Nutrition, food is no longer food and drink is no longer drink; but once you have had enlightenment, food is once again food and drink is again drink.” My goal is that by the end of this book, food has once again become food and drink has once again become drink for you. Hopefully you have realized that research has shown us conclusively that food does not have magical ‘weight loss’ properties and that any food can be part of a balanced weight loss plan. By following the Eat Stop Eat lifestyle you are able to lose weight by using an uncomplicated and stress free style of eating that balances your fed and fasted metabolism. This allows you to reap the health and metabolic benefits of short periods of fasting, including weight loss, decreased inflammation and improved metabolic profile, all while reducing the amount of time you stress about what you are eating. The bottom line is that with Eat Stop Eat, we can lose weight while creating a healthier relationship with food and accepting that food is: A) A fuel for your body when you need it And… B) To be enjoyed From this point forward, you can enjoy the foods you eat, and enjoy knowing that with the Eat Stop Eat lifestyle you can lose fat, build muscle, eat every day and not have to follow some crazy fad diet ever again, and be 100% positive that not only is taking the occasional break from eating not bad for you, but that it actually has tremendous health benefits. Eat Stop Eat 145 Eat less, stress less; move more, lift more and get a good night’s sleep. For physical health, that’s pretty much as good as it gets. Eat Stop Eat 146 Eat Stop Eat FAQs Q: I want to lose fat and gain some muscle. I’ve been told that I need to eat large amounts of protein every day to put on muscle mass. Won’t fasting cause me to lose muscle? No, as long as you are working out with strength training exercises you will not lose muscle. In fact, it is possible to gain muscle during Eat Stop Eat. Q: I’ve been trying the Eat Stop Eat lifestyle for several weeks now, but occasionally I get headaches when I’m fasting, what gives? There has been a lot of research on Ramadan fasting and headaches. It seems that women are particularly susceptible to headaches while fasting. This is not due to dehydration,231,232 and may actually be similar to withdrawal symptoms, similar to the headaches you experience when you quit drinking coffee cold-turkey. From my experience, if you experience headaches they do tend to go away after your first couple of fasts. If needed, you can treat your headache as you normally would when not fasting. Q: I’m really enjoying adding fasting into my eating plan, but I’d still like to clean up the way I eat when I’m not fasting, any tips? You can incorporate any diet style you like while you are following Eat Stop Eat. My personal opinion is that the general guideline of eating ‘lean and green’ with lots of Eat Stop Eat 147 fruits, vegetables, herbs and spices is an ideal complement to the Eat Stop Eat lifestyle, but you can incorporate any diet style you wish. Q: What are things I can do other than fasting to help me lose fat? My recommendation would be to look for small changes you can make in the way you eat when you are not fasting. Once you have gone without food for 24 hours a couple of times, you really start to get a feel for the real reasons behind why you eat, what you eat and when you eat. Often times, hunger isn’t one of these reasons. Habit and emotional connection are usually the culprits. If you take this new found wisdom, you can create a big difference in the way you eat by making SMALL, almost unnoticeable changes in your eating habits. Q: If I start the Eat Stop Eat Lifestyle, how quickly will I lose weight? It is a dietary truism that you can’t take off in a day what you put on over years. With the Eat stop Eat lifestyle, you should be able to lose weight at a rate of 1-2 pounds per week. However, for people who are exceptionally lean (Under 9% for men and under 19% for women) weight loss tends to be slower, generally between 0.5 and 1 pound per week. Q: Do I need to take a multi-vitamin on the days that I am fasting? No, a multi-vitamin is generally not necessary if you are eating a balanced diet. However, if you like taking multi-vitamins then by all means, continue to do so; they will not negatively affect the health benefits of fasting. Q: Will fasting affect my menstrual cycle? Generally the answer is no, even longer fasts have been shown to have little impact on the menstrual cycle of normal weight women.233,234 There is research, however, to suggest that longer fasts (72 hours) can affect the menstrual cycle of exceptionally Eat Stop Eat 148 lean women (body fat levels well below 20%).235 For this reason I do not recommend fasting for longer than 24 hours, and as always, if you do discover menstrual irregularities while losing weight please see your medical doctor or health care practioner. Q: I read that any weight loss from fasting is only water and muscle, not fat, and you regain the weight when you start eating again. Is this true? This is not true. During the actual period of time when you are fasting your weight will be lower than normal. This is due to the fact that you have no food in your system, and your body has shed some excess water. However, with several periods of fasting, the weight loss you see is very real and it is indeed fat loss. Q: I’ve heard that under-eating will slow my metabolism down and put me in “starvation mode” which will cause me to store more fat. Will this happen with the Eat Stop Eat lifestyle? No. On the Eat Stop Eat lifestyle you never go a day without food, and you spend most of your days eating your regular diet without changing anything. Your daily calories will only be lower on the days you start and finish your fast. The overall effect should come out to about a 15-25% calorie reduction over the entire week with no negative effects on your metabolism. Q: Are there any specific supplements I should take while I am fasting? If you have been asked by a qualified health care professional to take a certain supplement, then continue to do so. However, I do not believe there is any need for extra or special supplements during your fast Q: I’ve heard that short periods of fasting similar to the Eat Stop Eat lifestyle are being studied in animals. I’ve read it can increase their life expectancy. Is this true? Eat Stop Eat 149 Yes. As a matter of fact, this research is being done by Dr. Mark Mattson at the National Institute on Aging. Research suggests that animal’s age slower and live longer when they consume fewer calories. The research is showing that this effect can be achieved by eating less each day, or by fasting on intermittent days.236 Q: Why do I have to fast for 24 hours? Couldn’t I just do 18 hours, or 36 if I wanted more results? The answer is twofold. First: According to the research, the 24-hour point is right in the middle of the maximum adaptation for fat burning. Second: Through trial and error, many of my initial test subjects (including me) following an Eat Stop Eat lifestyle found that 24 hours was the least intrusive to their daily lifestyle. A 24-hour period made the most sense from a practical and scientific stand point. In actuality your body begins to burn significantly more fat four to eight hours after your last meal (depending on the size of your last meal). This effect begins to level off after 30 hours. If you don’t quite make it to the 24-hour point some days, don’t sweat it. You’re still getting a benefit. I do not recommend extended fasts by a considerable amount past the 24-hour mark because I believe they become too intrusive on a person’s lifestyle. There is nothing wrong with cutting a fast short at 22 hours, or extending a fast to 27 or 28 hours if it fits into your schedule. However, if you end up fasting for 40, 50 or even 70 hours I simply do not see how this CANNOT become intrusive on your life. By extending your fasts into the range of 2-3 days, you lose the flexibility that makes Eat Stop Eat so effective as a long-term weight loss solution. Eat Stop Eat 150 Q: I heard breakfast is the most important meal of the day. Will it affect me if I miss breakfast on a fast day? There is no scientific evidence to prove that breakfast is any more important than lunch or dinner for adults. As a matter of fact, there is no scientific evidence proving three meals per day are any better than one. Q: Can I follow the Eat Stop Eat Lifestyle if I am pregnant? No. Eat Stop Eat should not be used by anyone who is pregnant or trying to get pregnant. After your pregnancy, consult your physician to see if Eat Stop Eat is suitable for you and your individual circumstances Q: I know that black coffee, diet pop, and water are fine during my fasting periods, but what about sugar-free gum? I have used sugar-free gum during my fasts. Most of these gums contain 2-3 calories per piece, so I consider a couple of pieces of gum to be acceptable during a fast. Q: I’m a bodybuilder and I’m interested in trying fasting. Can I still take any of my supplements on the fasting day (I’m trying to gain muscle)? Lucky for you, the one supplement that is proven to increase strength and muscle mass in the long term is creatine monohydrate. And, since creatine is not metabolized for energy and does not raise insulin levels, taking creatine on your fasting days is perfectly acceptable (but I would still recommend taking your creatine at the times when you are eating). Q: I know you suggest weight training while following the Eat Stop Eat lifestyle, but what about other types of exercise like yoga or mountain biking? I absolutely encourage you to practice as many different types of exercise as possible. Just like nutrition, I think variety is the key to exercise and both yoga and mountain Eat Stop Eat 151 biking are excellent examples of exercises that compliment the Eat Stop Eat lifestyle. As long as you are doing some form of resistance training at least two or three times a week, you can add any additional exercises you wish. Q: My daughter is 14 and overweight, can she try the Eat Stop Eat lifestyle? Unfortunately, no, she cannot. All of the research conducted on fasting is done on adults; there is no way for me to know its effects on children. I only recommend Eat Stop Eat for healthy adults. Q: Do you think the Eat Stop Eat lifestyle would be beneficial to someone who is simply trying to maintain his or her current weight? Yes. Eat Stop Eat provides a simple way to maintain your weight. Instead of fasting once every 3-5 days, a person wishing to maintain their bodyweight could fast once every 6-8 days. Q: I’ve read that you need to eat every two to three hours in order to prevent your blood sugar from crashing, how does Eat Stop Eat affect my blood sugar? The truth about having low blood sugar is that it is not nearly as common as we are often led to believe. People who suffer from true hypoglycemia typically have a “hypoglycemia disorder”. This disorder is usually diagnosed by a medical test. What’s more, true hypoglycemia isn’t just ‘feeling tired’ but includes confusion, difficulty speaking, and even seizure and convulsions.237 For the vast majority of the healthy population, we are easily able to maintain healthy blood sugars that are neither toohigh nor too-low in a whole range of different situations, including fasting and intense exercise. In research examining the effects of a 24 hour fast, it was found that fasting did not cause blood sugar levels to dip below 3.5 mmol/Liter, meaning that during the entire 24 fast, blood sugar slowly lowered itself, but remained at normal non-hypoglycemic levels.238 Eat Stop Eat 152 Q: My Dad is really interested in Eat Stop Eat, but he is diabetic. Can he still try the Eat Stop Eat lifestyle? Eat Stop Eat was designed for healthy people trying to lose weight. If your father wants to try Eat Stop Eat, he should only do so under the direct supervision of a doctor or healthcare practitioner. Q: In the beginning of Eat Stop Eat you say that it can improve your health and “might just save your life”, these are some pretty bold statements. What gives? Right now there is ongoing research on short-term fasting and its ability to improve certain markers of health. While it would be premature of me to say that fasting can help with a medical condition, I can say that it has been used with success in clinical research on people who suffer from asthma,239 lowers inflammation,240 and is being studied for its potential to improve brain health.241 Q: What about post-workout nutrition? Don’t I need to eat immediately after my workouts? According to Dr. Michael Rennie of the University of Nottingham, the idea that there is golden period of getting amino acids into your muscles is speculative at best. What’s more, the American College of Sports Medicine recommends that athletes who take a day or two to rest between vigorous workout sessions do not need to worry about the timing of carbohydrate intake. The bottom line is that most of today’s post-workout nutrition advice serves three purposes – to possibly (please note the vagueness of that term) support the muscle building process in young (university aged) men and women who are just starting a workout program; to fuel the metabolic needs of ELITE athletes; and to help sell sports supplements. You can work out on your fasting days without having to worry about your post-workout nutrition. Eat Stop Eat 153 Q: With all the news about sugar being bad for you, shouldn’t I be cutting down on the amount of sugar I eat if I want to lose weight? You should, and you are. Think of it this way, If you are very diligent and watch the foods you eat day in and day out, skip desserts, and avoid many of the high sugar foods you normally eat, you might be able to reduce your sugar intake by 30%. Alternatively, you could keep eating the way you normally eat, and fast for two 24- hour periods over the course of a week, and still reduce your sugar intake by 30%. By fasting for two days out of 7, you automatically reduce your sugar intake by about 30%, just by missing two 24-hour periods of eating. The Eat Stop Eat lifestyle is a great way to get the exact same result as a restrictive diet WITHOUT spending day after day monitoring every piece of food you put into your mouth. Q: I’ve read that high protein diets can help with weight loss. Can I eat highprotein while doing Eat Stop Eat? Yes. There are several published research studies suggesting that a higher amount of dietary protein might be associated with an increased rate of weight loss (As long as the diet is calorie reduced). Most of the research I’ve reviewed have had people eat between 70 and 150 grams of protein per day (not the crazy 250 grams of protein per day suggestions that you find in fitness magazines). If you like, you can definitely try eating a higher protein diet while using Eat Stop Eat. Q: What is the best thing for me to eat after I am finished fasting? When you finish your fast you need to pretend that your fast NEVER HAPPENED. No compensation, no reward, no special way of eating, no special shakes, drinks or pills. The minute you decide to stop fasting, you need to wipe the fast from your memory, and eat the exact way you would normally eat at that specific time of the day (while eating responsibly of course). If you end your fast at dinnertime, have dinner. If you end your fast at 4:00 PM and you don’t typically have dinner until 6:00 or 7:00 PM, Eat Stop Eat 154 then have a light snack…but nothing larger than you would normally have at that time. There is no magic way to end your fast. The absolute best thing you can do is simply pretend your fast never happened and begin eating in the exact way you would normally eat at that specific time of day. Q: Can I have a little bit of non-fat milk in my coffee while I am fasting? Unfortunately my answer is no. I would recommend you try to fast without making little concessions in your diet. While I do admit that small amounts of calories probably will not interrupt the fasting state metabolism, I am still concerned that fat free (non-fat) milk still has too many calories for when you are fasting. Stick with calorie-free beverages as much as possible while you fast. My answer would be the same for a small amount of cream or sugar. Q: Can I drink juice while I am fasting? I do not recommend drinking any juice while you are fasting. From my experience, using a juice fast for weight loss can be disastrous. Remember, the key to Eat Stop Eat is to try and consume NO calories for 24 hours. Juice is high in calories, so it is like drinking liquid food, and much less filling...if you think about it, this is actually depressing - you get the calories without the pleasure. In my opinion this defeats the whole purpose. Q: I want to fast every day except weekends, does it make a difference if my fast lasts for 23 hours instead of 24 hours? I don’t think there is a large difference between 23 and 24 hours. That being said, I must say that I do not endorse the practice of fasting for such a large length every single day. The point of Eat Stop Eat is to add flexibility to your diet plan, not remove flexibility, which is essentially what spending 23 hours of fasting every day would do. Eat Stop Eat 155 I urge you to try fasting once or twice a week first, I’m sure you will be surprised by the effectiveness of this simple approach. Q: I was wondering if there was any research on the effects of fasting on a women’s menstrual cycle? There is some research that looked at the effect of short-term fasting on the menstrual cycle of women. These research studies found that despite the metabolic changes that occur during fasting, even fasts as long as 72 hours do not seem to have an effect on the menstrual cycle of normal cycling women.104 However, if you have any questions or concerns about your menstrual cycle you should discuss them with your doctor or health care practitioner. Q: So are you saying that (insert newest style of eating here) is wrong? No, not at all. There is no wrong way to eat. The only thing that can be wrong, or scientifically incorrect, is the explanation of the benefits of a particular way of eating, or the reasons why one type of eating is ‘better’ than another type of eating. Q: What about post-workout nutrition - Do you think it is necessary to have high glycemic carbohydrates after training? I really don't see any need for high-glycemic carbs after training unless you are an endurance athlete and need to replenish glycogen stores. Even then, it would only be if you have to compete again in very short period of time (24-48 hours). For general muscle growth and well being, I think carbs are one of the most overrated post workout foods. With typical eating, your glycogen stores will be replenished to their maximum within 48 hours after your workout. Unless you are doing multiple endurance style events in the same day, I see emphasis on high carbohydrate intake as just another obsessive-compulsive eating habit that can wind up causing us to gain weight. Eat Stop Eat 156 Q: I really enjoy the idea of a cheat day while I’m dieting. Can I do a cheat day with Eat Stop Eat? I really don't see any reason why you can’t. If you want to have a big day of eating every once in a while, and if this makes you happy, then I am all for it with three reservations: 1) As long as your overall calorie intake averaged over the week remains low. 2) The cheat day doesn’t make you feel guilty or depressed the next day. 3) You aren’t force-feeding yourself to the point of feeling sick in the hopes of having some beneficial health or fat-loss effect. Q: Sometimes when I fast my finger tips get cold, why is that? Fasting increases the blood flow to your body fat (the process is called adipose tissue blood flow).242 So when you are fasting more blood is travelling to your body fat, presumably to help move it to your muscles where it can be burned as a fuel. Due to this increased travel to your body fat, vasoconstricton occurs in your fingertips and sometimes toes to compensate. So in some cases it’s a ‘necessary evil’ in the fat loss process. Q: I noticed you said the chronic inflammation can negatively affect muscle building, but I heard that taking high doses of anti-inflammatory after your workout can also negatively affect muscle building…I’m confused. While CHRONIC inflammation can negatively affect the muscle building process, ACUTE inflammation seems to be involved in the muscle building process in a positive way. So the difference lies in chronic being bad, while the proper type of acute inflammation may indeed be beneficial. (Also keep in mind that those studies on antiinflammatory drugs having a negative effect on muscle building were using very high doses243, studies on lower doses did not show this same affect.244) Eat Stop Eat 157 Q: What is your opinion on taking Branched Chain Amino Acids during a fast? The branched chain amino acids leucine, Isoleucine, and valine are a family of essential amino acids that are extremely important to muscle physiology – including growth and repair. The BCAAs (specifically leucine) act through a protein-signaling pathway regulated by something called mTor to initiate the process of protein synthesis, which at time can initiate the process of muscle growth. While some people recommend BCAAs during a fast to prevent muscle growth, I see some issues with this suggestion. To start, there is little evidence to suggest muscle loss should be a concern during short term fasting. Secondly, mTOR is not exclusive to muscle, it is found in almost every cell in the body, and plays an important role in dozens of processes within the human body. The main reason I do not recommend BCAA intake during a fast is that mTOR is a strong negative regulator of autophagy245 (see the chapter on ‘cellular cleansing), and even small doses of BCAA can increase insulin (another negative regulator of autophagy) and initiate mTOR driven decreases in autophagy.154 So there seems to be very little benefit to BCAA supplementation during a fast, considering that you may be eliminating the health benefits of the fast. Better to keep your BCAAs to the end of your fast and during the times you are eating. Q: Sometimes when I fast my stomach ‘growls’ any tips to avoid this? Yes, for some reason I find sparkling water (Pelligrino, Perrier) tends to help. I’m not sure why, but it tends to calm a growly stomach. Q: You never actually say how I should eat on days I’m not fasting? Should I still eat 6 times per day? You should eat in the way that fits your lifestyle best, while allowing you to keep calories under control and still be able to eat the foods you enjoy. If you review the Eat Stop Eat 158 body of scientific literature on eating frequency (how many times you eat in a day) you find very unremarkable results in either direction. Forcing people to eat more often can be disastrous as some researchers have speculated that our growing obesity crisis can be blamed on eating more often as much as it can on increased portions sizes.246 However, forcing someone to eat less frequently may end in increased portion sizes. Based on this I cannot offer a ‘perfect’ way to eat because it simply does not exist. You have to find what works for you right now, and be willing to change the way you eat as your life changes. Q: I’ve heard that people are using fasting with chemotherapy treatments, why is this? Fasting is being studied as an addition to chemotherapy as very preliminary studies have found that fasting seems to reduce the side-effects typically associated with chemotherapy, including fatigue, weakness and gastrointestinal side effects.247 However, much further research is needed before short-term fasting becomes a recommendation for patients undergoing chemo. Q: I’d like to fast twice a week, but I’m worried about missing my post workout meal, can you help me? Without going into the science for and against the idea of post workout meals, I will say that if you are fasting twice per week, and training less than 5 times per week, you should be able to always find a way to time your fasts and workouts so you can always have a post workout meal. 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