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A Better Diet: The Evidence for Intermittent Fasting

Bioenergetics Circuit

By: Michael Lam, MD, MPH; Carrie Lam, MD; Jeremy Lam, MD

An image of a white plate with a clock on it, surrounded by cutleryHealth fad diets come and go. Some of them can be helpful, while others can actually damage your health. And it can be difficult to decide which fads belong in which category. There’s always a risk of choosing a strategy that turns out to be useless or even harmful to your health. That’s why it’s always a good idea to look at the research before deciding to change what or how you eat. The evidence for intermittent fasting is growing at the moment, and it seems to be living up to the hype. The practice of fasting may sound a little worrisome and extreme, but the evidence suggests that it can be extremely beneficial in some situations. If you’re thinking about trying this health fad to lose weight, reduce inflammation, or recover from a chronic health condition such as adrenal fatigue, here’s how to do it safely and effectively.

What is Intermittent Fasting?

Intermittent fasting is a health fad that seems to be sweeping the world. However, it can be difficult to pin down exactly what people mean by intermittent fasting because it isn’t just one thing. Basically, intermittent fasting involves periods of normal, healthy eating, and periods of fasting, or not eating at all. There is a lot of evidence for intermittent fasting showing that it can improve metabolic health, help with weight loss, protect against certain health problems, and even extend your life.

One of the big reasons this health trend is popular is because it’s about when you eat rather than what you eat. Though it obviously isn’t a good idea to eat processed or very sugary foods during your eating periods, as long as you eat a healthy diet, you should enjoy some benefits from this way of eating. You can also drink water, coffee, tea, and other beverages without calories during the fasting period, so dehydration isn’t usually a worry. There are lots of different fasting routines to follow if you decide to try this strategy. Some of the most popular fasting routines include:

  • The 16/8 Method - This is probably the most popular way of employing this tactic. On this schedule, you fast for 16 hours a day and only eat within an 8-hour window. So, if you eat your last meal at 8 p.m., you need to refrain from eating until noon. Then you can eat until 8 p.m. again.
  • The 5:2 Diet - For this method, you eat normally for 5 days a week and fast on the other 2 days. On the fasting days, you’re only allowed around 500-600 calories.
  • Eat-Stop-Eat - This eating plan allows you to eat normally most of the time. But once or twice a week you refrain from eating for 24 hours, usually from after dinner. And this fasting period lasts until dinner the next day.

Although these methods might sound difficult, most people report that they’re actually fairly easy to stick to. This is particularly important because it means that you shouldn’t find it difficult to continue using fasting as a long term strategy to improve your health.

The Best Type of Intermittent Diet

There are several different types of intermittent fasting routines, but the evidence for intermittent fasting suggests that one type may be more useful than others. All these fasting routines have the potential for weight loss and other health benefits, but not all of them affect the deeper processes in the body and decrease inflammation or affect longevity.

The evidence for intermittent fasting supports the Fast Mimicking Diet (FMD). This method follows a routine of 5 days of reduced calories and 25 days of healthy eating. The regimen combines mild calorie restriction, protein restriction, and specific rations of low GI foods. According to studies, it’s the only diet that affects the IGF-1 pathway, which can help reverse diabetes and slow down the signs of aging. Participants in a recent human study performed to test the efficacy of the FMD diet noticed the following results:

An image of a woman showing how intermittent fasting can help slow the signs of aging

  • Loss of abdominal fat.
  • Their metabolic panels improved, which means better cholesterol and blood pressure control.
  • C-reactive protein levels decreased, which indicates less inflammation in the body. The changes in the C-reactive protein levels persisted for 3 months after the end of the study.
  • A significant improvement in the number of stem cells in the circulating blood, which is essential for tissue repair and regeneration.

Why Does it Work?

There is a lot of evidence for intermittent fasting, most of it identifying distinct and important health benefits. But the question is, why does it work? The answer lies in the evolutionary past. Humans have a long history and, for a big part of it, fasting was normal. When humans were hunters, food intake depended on how well the hunt went, which means that when it went badly, they didn’t eat. That’s why the human body is designed to cope with fasts, otherwise, we would never have survived this period in history.

When you fast, a lot of processes in the body change to keep you alive. Most of these changes have to do with hormones, genes, and cellar repair processes, and these changes are the key to the many health benefits of intermittent fasting. According to the evidence for intermittent fasting, here are some of the benefits you could enjoy if you adopt this strategy:

  • Improved metabolic activity.
  • Weight loss or better weight control.
  • Protection against diseases such as heart disease, diabetes, and cancers.
  • Decreased inflammation.
  • An extended lifespan.

Who Shouldn’t Fast?

Despite all the evidence for intermittent fasting, that doesn’t mean that this regimen is right for everyone. In some cases, it may exacerbate certain disorders or diseases or even damage your overall health. This fasting routine is generally considered safe for most people between the age of 17 and 70, but there are some specific issues and problems which could increase its danger. The following people shouldn’t fast:

  • Women who are pregnant, nursing, or trying to become pregnant.
  • People who are already underweight or who have a BMI of under 18.5.
  • People who are in heart failure.
  • Anyone over the age of 70.
  • People who have type I diabetes and require insulin and regular eating to stay healthy.
  • Anyone with liver or heart disease.
  • People with type II diabetes who are insulin dependent.

If you fall into any of these categories, it’s important that you don’t try intermittent fasting. However, if you don’t have any of these issues, make sure that you get help and supervision from a trained medical professional before you make any major life changes. They will be able to ensure that you’re in good physical condition and can withstand the stress of this type of eating plan.

The Evidence for Intermittent Fasting

An image of an insulin needle and various pills surrounding the word diabetesThere have been numerous studies designed to gather evidence for intermittent fasting. And unlike most health fads, this one seems like it might actually be good for your body and your long-term health. People often try intermittent fasting because they’re concerned about issues such as diabetes, heart disease, and weight loss, and this tactic may help with all of these issues in the following ways:

  • Enhanced autophagy - This is the natural disassembling of damaged or unnecessary cells, so they don’t “clog up” your system. Autophagy is essential because your cells can’t function properly if they contain extraneous or useless components. If your cells aren’t clean it will cause more inflammation and the cells themselves will struggle to perform their duties. They may even die from the overload, which will cause even more problems. The evidence for intermittent fasting suggests that it can encourage autophagy, which will enhance cellular regeneration and cellular health.
  • The restriction of key cellular growth paths such as IGF-1 - Intermittent fasting can restrict the IGF-1 pathway. IGF-1 is a hormone that’s essential for growth during early life, but as time goes on, it can cause advanced aging. By restricting this pathway, intermittent fasting can slow down the effects of aging and promote better health over the long-term.
  • Inhibition of the AKT and PI3K pathways - These are signaling pathways that work to regulate the cell cycle. However, they also have the secondary effect of inhibiting FOXO factors. These are transcription factors, genes that have a key role in longevity and the maintenance of glucose balances. These genes also help to regulate the immune system. So, if the AKT and PI3K pathways are inhibited, as the evidence for intermittent fasting suggests occurs through these types of regimens, FOXO factors can become more active. This will help to reduce inflammation and help you live a longer and healthier life at the same time.
  • Better control over or reversal of diabetes - Diabetes is a serious problem that has numerous health consequences. People with this disorder are usually on multiple medications including those that lower blood pressure, blood sugar, and cholesterol levels. Unfortunately, these measures are essential because diabetes is linked to several serious complications. For a long time, diabetes was thought of as irreversible, but now the evidence for intermittent fasting suggests that it can help to control or even reverse insulin sensitivity in some people.
  • Improvement of metabolic syndrome - This is a cluster of diseases that results in serious health problems such as heart disease, diabetes, insulin resistance, high blood pressure, and poor levels of healthy cholesterols. The evidence for intermittent fasting suggests that it can help to correct these problems and promote better overall health.
  • Inflammation reduction - The evidence for intermittent fasting suggests that it can regulate the microbiota, the circadian rhythm, and inflammation levels. These are incredibly important benefits regardless of your health level. Inflammation circuit imbalances are common when you have adrenal fatigue and many other conditions, and the only way to correct them is by rebalancing the organs and systems in this circuit. This means improving the health of the gut and rebalancing the bacteria that live in the body. If you neglect this step, it can result in serious health issues such as diabetes, which will further exacerbate other health conditions.

The Dangers of Inflammation

Inflammation is rapidly becoming one of the biggest health threats in the modern world. This is partly because it’s so hard to identify. It isn’t something that you can see from the outside, although high levels of inflammation can be detected through certain blood tests. And it is linked to many health problems and diseases.

Inflammation typically occurs when your body is fighting off something harmful. It’s actually a natural process prompted by the immune system that causes redness, swelling, and heat in an attempt to expel invaders. This is a normal and helpful process. However, it isn’t just harmful invaders that cause inflammation. Other factors such as a poor diet, environmental toxins, certain diseases, emotional or mental stress, and a sedentary lifestyle can also increase inflammation levels. And these causes can’t be expelled from the body, which often results in chronic inflammation. This is a low-grade inflammation that has no target and so just builds up in the body, clogging its systems and causing damage. If left unchecked, this type of inflammation can result in autoimmune diseases, heart disease, cancer, diabetes, and adrenal fatigue. People who have a combination of serious disorders like these often have chronic inflammation that may be causing or exacerbating their health problems.

How Chronic Inflammation Can Lead to Breakdown

NEM Bioenergetics CircuitYour body is designed to cope with different types of stress. It does this by activating the NeuroEndoMetabolic (NEM) Stress Response, a network of six circuits of organs and systems that prepare the body to respond to stress. The NEM stress response is a system that’s designed to cope with short term causes of stress such as a physical threat. But it isn’t designed to cope with chronic, ongoing stress caused by harmful factors such as a poor diet, lack of exercise, environmental stressors, work and relationship pressures, health conditions, or chronic inflammation.

When you experience this kind of stress, the NEM stress response activates, which prompts the release of cortisol from the adrenal glands. Cortisol is a hormone that has several essential functions in the body. During times of stress, it prepares your organs and systems to fight or flee. But like most things, too much cortisol can be a problem, and it’s even worse when the demand for cortisol is high over long periods of time. This can leave your system in a constant state of tension and readiness, leading to adrenal fatigue.

People with adrenal fatigue experience a feeling of being wired and tired, widespread NEM circuit dysfunctions, and baffling symptoms that no one seems able to identify or correct. Having AFS, or Adrenal Fatigue Syndrome, can be very frustrating and frightening until you find someone who understands what’s happening and can help you make changes to address the problems. However, key evidence for intermittent fasting now suggests that this strategy may be very useful in this path to recovery from mild forms of AFS and the circuit imbalances it causes.

The Role of Inflammation Circuit Dysfunction in AFS

The inflammation circuit usually becomes unbalanced very early on in AFS. This circuit includes the immune system, your gut, and your microbiome, composed of all the microorganisms that live in the various environments in your body. These three components have vital roles when it comes to inflammation.

The gut issues are often a source of inflammation. When there are problems with the gut such as constipation, diarrhea, or food sensitivities, it can cause the lining of the gut to become more permeable, which allows unwanted particles through. This is often known as “leaky gut”. This triggers the immune system and can cause inflammation. Normally, the inflammation repels the invader, and your system returns to normal. But when you have AFS and chronic stress, inflammation and gut problems can linger and end up affecting the rest of your body, including your brain.

These same gut issues can cause your body to struggle to digest food properly and affect the balance of good and bad microorganisms in your the body, creating a state of dysbiosis. This type of imbalance has been implicated in conditions such as diabetes, cancer, and obesity, and it can also result in infections and mental disorders. Obviously, bacterial imbalances also lead to activation of the immune system, as it must work to fight off the infections that occur. And this results in even more inflammation.

Correcting this type of problem isn’t easy. However, the evidence for intermittent fasting suggests that this might be a new avenue of help in a variety of ways.

How Intermittent Fasting Could Impact AFS

AFS is usually associated with a range of troubling symptoms and disorders. This is part of what makes it so difficult to correct, because it causes widespread problems that don’t seem to be connected to any one disorder or disease. However, the evidence for intermittent fasting suggests that it could help with a lot of these symptoms and problems. This includes the following very common symptoms:

  • Insomnia - Intermittent fasting can help to regulate the circadian rhythm, which is the body’s sleep/wake cycle, which could help you to establish normal sleeping patterns.
  • Blood sugar instability - This is another common symptom of AFS. Intermittent fasting helps to activate FOXO factors, which can help with maintaining a healthy glucose balance.
  • An image of healthy food surrounding a chalkboard heart with mindful eating written on it

  • Weight gain, usually around the waist - The evidence for intermittent fasting suggests that this regimen is one of the best ways to reduce weight. It can also help to reverse certain age-related changes. One of the problems with aging is the way it changes how your body stores and processes food. Often this means that, even if you keep the same diet as you age, you will naturally put on weight or store it around your midsection. However, intermittent fasting reverses a number of these age-related changes which can help you maintain a healthier weight.
  • Mood disruptions and disorders - People with AFS often experience mood disruptions and disorders such as anxiety and depression. This is often related to neurotransmitter imbalances and to problems with the balance of good and bad bacteria in the gut. Recent research has established that your gut health is essential to your brain health. So, by improving the health of your gut through intermittent fasting, you will also help to stabilize your moods.
  • Better digestion and elimination - People with AFS often experience fluctuating cycles of diarrhea and constipation as well as other gut related issues. In fact, for some people, this can get so bad that it results in malnutrition as the gut struggles to absorb the nutrients that that body needs. The evidence for intermittent fasting suggests that employing this tactic will help to rebalance the microbiota in your gut, encourage the growth of good bacteria, and promote the return of a healthy digestion and elimination cycle.

Healing AFS Through Your Diet

When you have AFS, addressing the individual symptoms doesn’t solve the problem. Instead, you need to work on reducing stress and rebalancing the circuits of your NEM. This often isn’t easy. It means that you must reduce the sources of stress in your life such as work or relationship pressures, poor dietary habits, a sedentary lifestyle, environmental toxins, and other harmful factors. And this can be a long process with lots of starts and stops, particularly if you don’t have the help of a medical professional who’s aware of AFS and its effects.

A healthy diet is essential to AFS recovery. Typically, this means a diet that’s high in vegetables as well as lean proteins, healthy fats, and whole grains. Equally important is the elimination of processed foods as well as foods that can cause sensitivities such as gluten. This will give your body the nutrients it needs to fuel the healing process. Adopting this type of diet will help to rebalance your entire system, including the inflammation circuit.

Maintaining a healthy diet and steady blood glucose level is important to avoid the reactive hypoglycemia frequently experienced by many with AFS. Evidence for intermittent fasting suggests that this could be a beneficial part of that process if the body is healthy enough, as in the early stages of AFS. However, for a person in the advanced stages of AFS, intermittent fasting can trigger adrenal crashes because the body simply does not have the energy reserve to go on too long without food, such as for a long overnight fast. If you have advanced AFS, it’s best to restore your health through other methods, and only try intermittent fasting when your body is healthier.

Balancing the Inflammation Circuit Through Intermittent Fasting

One of the keys to recovering from AFS is reducing inflammation and rebalancing the inflammation circuit. To rebalance this circuit, its three components must be returned to good health and full functioning. Here’s how the evidence for intermittent fasting suggests it can help:

  • Regulating and deactivating the immune system - Studies show that intermittent fasting causes the restriction of pathways that inhibit FOXO factors, which can help to regulate the immune system. This will help to calm immune system overactivity and reduce inflammation in the body. It may also help you to avoid developing autoimmune diseases, which can often result from an overactive immune system.
  • Improving gut health - Intermittent fasting can help to restore healthy balances of bacteria in your gut, which will help you establish normal elimination and digestion patterns. This will naturally reduce the amount of inflammation further, giving the immune system more time to rest.
  • Better microbiome health and balance - The balance of good and bad bacteria throughout your body is absolutely essential for your continued health and wellbeing. There are more bacterial cells inside your body than there are your own DNA cells, so when this balance becomes disrupted, the results can be catastrophic. The evidence for intermittent fasting shows that it can help restore the balance of bacteria in the gut. It can also help to enhance autophagy, or the removal of damaged or unnecessary cell matter. This naturally improves the overall health of the body’s cells as well as the beneficial bacterial cells. It also aids the removal of wastes and toxins clogging up the body’s systems and encourages a return to better health.

An image of someone suffering with inflammation of the digestive systemThe three systems in the inflammation circuit always work in tandem. So, when one becomes unbalanced, the others naturally follow. But the reverse is true as well. When you improve the health of the gut, it helps reduce inflammation and encourages a better balance of good and bad bacteria. This decreases the overactivity of the immune system, markedly improving the health and balance of the inflammation circuit and decreasing your body’s stress levels, giving your adrenal glands a chance to rest and recover.

A Warning If You Have AFS

As noted above, despite all the evidence for intermittent fasting being positive for those who are healthy or in mild AFS, you still need to be careful when you adopt this strategy if you have moderate to advanced AFS. When you have AFS, your entire system will be delicate and may overreact to additional stress.

This can cause issues such as an adrenal crash, where the body returns to a state of low physiological function so that it can rest and recover. Basically, this can mean that you’ll be unable to leave your bed for a long period until your body has recovered enough to face daily life again. Adrenal crashes often occur during AFS after a period of heightened or acute stress such as a bereavement or acute infection. But if your system is very sensitive because of AFS, a period of fasting could be enough to bring on this type of crash as well. This is the last thing you want from a strategy that’s meant to help you recover from AFS, not make your health worse.

The only way to avoid this is to work with a trained professional who’s aware of AFS and of your struggle with it. They will have the experience and the training to tell if intermittent fasting would help or hinder your individual recovery and design a personalized plan that suits your condition and goals. So, even if the evidence for intermittent fasting makes it sound like a beneficial strategy for your health, don’t try to adopt it on your own if you have AFS. Without proper support, there’s too great a risk that it will only lead to further problems.

The Takeaway

No matter how well certain health strategies work for other people, they have to work for you. Your body and your condition are different than everyone else’s, which is why trying to adopt other people’s health strategies often doesn’t work and can even damage your health. As a result, despite the evidence for intermittent fasting, you need to be careful when you try this technique. Get the help of a medical professional who’s aware of your condition and of your AFS and can help you adapt the practice to suit your body and your physical condition. This will help you avoid some of the consequences of this practice while still enjoying its benefits.

© Copyright 2021 Michael Lam, M.D. All Rights Reserved.

Dr. Lam's Key Question

There is a growing body of evidence for intermittent fasting. This practice was once dismissed by health experts. But now, studies are showing that there can be some very important health benefits to adopting this practice including reducing inflammation and supporting weight loss.

© Copyright 2001-2021 Michael Lam, M.D. All Rights Reserved.
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