I could eat the foods I enjoyed and most of my regular meals, but it had to be within a short time frame of eight to 10 hours.
This post originally appeared on the New York Times
At the urging of doctor friends and a few popular books, I embarked on a diet plan earlier this year called intermittent fasting. The basics are that I could eat the foods I enjoyed and most of my regular meals, but it had to be within a short time frame of eight to 10 hours. Outside of that, I would stick to water, tea and black coffee.
Proponents of the plan, also known as time-restricted eating, say that intermittent fasting could help me lose weight, always a worthwhile goal. It would also give my gut a much-needed break from processing food, improve focus and lessen daily inflammation. In the long-term, it might even help me live longer.
I’ll admit, the words “intermittent fasting” sounded a little daunting. But Dr. Jason Fung, author of “The Obesity Code,” assured me that it could easily be incorporated into my daily routine.
“Anytime you’re not eating is a fast — anything above four hours is fasting,” he said. “A lot of times people eat because they have to, versus really enjoying what they are eating. If you don’t want the sandwich, skip it. Your body knows what to do, it will take your body fat. That’s why you carry it around with you.”
In other words, by voluntarily submitting to an absence of food for long periods during the day, my body would transition from burning sugar for fuel to burning fat.
Two things made me think I might be able to stick with an intermittent fasting plan. First, I have Type 1 diabetes, which means eating requires thinking. For most of my life, I have spent my days making in-air computations about what I might or might not consume: weighing pros and cons about specific foods while factoring in things like carbs, fat and fiber. Protein too, if I’m super diligent. The more I eat, the more I have to think.
Second, last year I had been on the Whole30 program, which involved staying away from most of the foods I love: no wheat or grains, no dairy, no soy, no sugar, no alcohol. Even foods I thought were healthful, like chickpeas, were forbidden. I loved the diet for its rigid rules, but each time I attempted to stick to it after the initial 30 days, I would eventually fail. Travel would crop up, or dinners out. It was about as flexible as Cersei on the Iron Throne.
The first step on my intermittent fasting journey was deciding how long to fast. Studies of the diet are still in their infancy, and time frames during which you’re allowed to eat vary in length, typically from eight to 10 hours. Some research suggests shorter may be better, so I went with eight hours, eating my first meal at 11 a.m., and finishing my last by 7 p.m. A decades-long late-night snacker, I vowed that the only thing to pass my lips after dinner would be herbal tea. Then I went to the market, bought some fancy teas, and prayed.
Once I decided on my schedule, the rest came easily. I fell into a nice pattern that included, typically, two meals a day and a small snack somewhere in between. I stuck mostly to the whole foods I loved: salads, eggs, fish, vegetables, yogurt, nuts and fruit, and the occasional square of dark chocolate or cookie.
Unlike Whole30, time-restricted eating offered me the latitude I needed. I could have that glass of wine, I could eat that wedge of cheese, and I could go back to loving chickpeas — my spirit animal legume. The beauty of this diet was that it was more about when I was eating than what I was eating. I could eat anything — and as much as I wanted! — as long as it was during my nonfasting hours. Although always mindful, it was a relief to be unburdened from calorie counting.
Intermittent fasting also provided a more Zen-like approach to my waking hours, a change that I soon came to realize I desperately craved. Because by no longer eating three to five meals a day, my mental load — the one I have from living with diabetes — went “poof.”
Dr. Jake Kushner, a pediatric endocrinologist formerly at Baylor College of Medicine and now with McNair Interests, a private equity firm, understood my pain. “People with diabetes can slay it really well, but they have to wake up tomorrow and slay it again,” he said, something I knew well from my life with Type 1.
Dr. Kushner asked me to come up with a number between one and 10. “If you add up the time you spend thinking of diabetes, that’s your cognitive load. Number one is you know you have it, but you don’t think about it. Ten is you only think about diabetes and it dominates your thoughts.” The number I gave him was 7, based on a lifetime of eating with Type 1. But by adopting intermittent fasting, that cognitive load number was steadily dropping.
Because I was eating only two meals a day, I took less insulin. For the first half of my day I could happily plug away on my laptop, sip my coffee and virtually ignore my blood sugar levels. While initially I felt hunger pangs, they soon passed, and I found myself waiting hours longer on some days before taking my first bite. I’ll admit: I liked being in control of my body.
While intermittent fasting was easy to adopt, I was far from perfect, and most weeks had me falling off the wagon, especially on days when I ate out with friends, which made me wonder if I was canceling out any potential gains. I took my question to Dr. Satchin Panda, author of “The Circadian Code” and a researcher at the Salk Institute.
Dr. Panda assured me that I was still getting benefits on my days off. Just like me, the mice in his studies got the weekends off and were allowed to overeat. “Yet, most of the benefits of time-restricted eating were sustained,” he said. “These include reduced body weight, reduced body fat, reduced cholesterol, better glucose control, reduced liver fat, increased endurance and better motor coordination.”
I definitely noticed I slept better. “Not having food in our stomach helps us with deep sleep in the night,” Dr. Panda said. “If you are doing time-restricted eating, your sleep drive will increase, and sleep will be much better,” though he noted that the mice he studied couldn’t tell him this.
Dr. Panda said that the No. 1 killer globally is heart disease, and that studies have shown that fasting, which often leads to caloric restriction, increases the life span even of healthy people. Studies also suggest that fasting may reduce tumor growth and could help to prevent recurrences of breast cancer and more.
“What we’re seeing is the first wave of this research,” Dr. Panda said. “The second wave will come in 2020, when we’ll see more rigorous studies on disease. We’ll also look at adverse side effects, because the absence of side effects in these observational studies doesn’t mean there are none.”
What I personally know is this: When I’m fasting, my mental clarity is a boon to my work, and my blood sugar has less variability — a side effect that’s a payoff for all (studies have shown that blood glucose variability is a good marker for the likelihood of a risk to developing diabetes). Then, when I’m sleeping, my blood sugar remains in a more constant, healthier range, without the usual food-related surprises.
I also continue to watch my mental number drop, the one Dr. Kushner recommended I track. On a good day of intermittent fasting my mental number felt like a 3 or 4.
But I can’t help but think of another of Dr. Kushner’s suggestions. “You should play with the keto diet at some point,” he said, referring to a diet that restricts the amount of net carbs eaten on a daily basis to, ideally, less than 20 grams. The mainstays of the diet are animal proteins, dairy, fats and very specific low-carb vegetables like cauliflower, broccoli and zucchini. “People with keto say 2,” he said. “What happens is your glucose variation goes away. You get your life back. You get to think about other stuff. Type 1 robs people of their ability to be human, to be unique, to think about other things.”
But with my newfound happiness in intermittent fasting, I’m not ready to adopt another new set of eating rules. Maybe next year.